Sondre

Most of us will experience several crises during a lifetime. Insanity as a result of sudden shocks that life provides can manifest in different forms. In this article we examine life crises and how to handle them. How do we relate to the Shock of it all? What distinguishes those people who come out stronger from the crisis, and what about those who never really recover?

Insanity as a result of sudden shocks that life provides can manifest in different forms. Neely and Murtry describe the hallucinations that Mrs. Lincoln underwent after her husband was assassinated. Having lost two of her children prior to her husband’s death and one more after it, she started to feel afraid about her last living son. Their book details how the signs of Mrs. Lincoln’s weak mental state were apparent long before her husband’s death. The sudden availability of money when her husband came to power, led her to splurge on inanities – eighty four pairs of kid gloves, lavish draperies and furnishings – at a time when the economy was under severe distress. She seemed to find solace from loneliness and grief by shopping outrageously.

Her condition went on to become hallucinatory, she was convinced she heard voices, was about to be a victim of murder, and feared excessively for her last living son – who was successful and in good health. At some point, she concluded that her son was out to kill her. Over time, her condition became apparent to the observer. Reckless spending alternated with extreme hoarding. She hid her money from possible robbers by sewing large sums in the hem of her dress.

The young star

Media reports provide rampant coverage of the bizarre antics of young stars who get famous early and lose themselves. The constant attention, the need to be in the public eye and the varying reports that touch all aspects of a person’s life are addictive and stressful. At the same time, the media and the public outrage over the slightest misdemeanours and the assumption that the star is an icon or a guiding light to other youngsters places the person on a shaky pedestal – one that will fall at the first mistake. The move from rags to riches, the bliss of being in the limelight after years in obscurity can often be too much of a shock to the mind. Add to this, the use of mind-altering substances that warp the sense of reality and toy with judgment can lead a person severely astray.

Answers from religion and philosophy

How does one deal with the shocks that life deals to them? Religion and philosophy provide answers to those with faith – the answers lie within, but a troubled mind becomes less and less able to depend on itself and seeks alternate avenues on the outside. The search leads to extreme religious rituals, willingness to forgo the routines of normal life in order to appease an invisible entity and the development of a rigid fundamentalist attitude towards people of other beliefs.

Losing a child

Deborah’s two year old slipped out of her grasp and ran into the middle of the road with her mother screaming behind her. A speeding car knocked the child dead and left Deborah a weeping mass. She was quickly reduced to a childish, waif-like existence who no longer knew how to care for herself. She remained in this state through her lifetime.

Denise, on the other hand, nursed her infant knowing that it would not survive. In those times, a blue baby had little chance of survival. She wept, she ranted but when the end came, she accepted it as a lesson in faith. She continued with her life and went on to bear two children. She always bore the memory of her lost child but returned to normalcy.

How does a family cope with these situations?

Mac had a job with an IT company. He had grown up the ranks and was now a respected director in charge of manufacturing and quality. One day, he reached the office to find that the offices had been sealed. He was taken by the tax authorities for a grueling round of questioning. He was disallowed from calling his family or even going to relieve himself. At the end of the interview, Mac was left a shriveled and shivering human being. He had no access to information about the fraud that had been perpetrated by the owner of the corporate or that he had been an unwitting signatory to a document that directly placed the blame of the wrongdoings on him.

He found himself hauled off for further rounds of questioning in a state of increasing confusion though it was becoming clear that his meteoric growth had in large part been due to his blind loyalty and whole-hearted agreement with anything that the owner of the company wanted. This was his undoing. After a week, Mac was allowed to meet his family. He wept bitterly as he recounted what he was beginning to understand about the whole situation.

His wife and children watched helplessly as Mac was hauled over the coals for his implicit involvement in the illegal actions of his superiors. It took more than a year of incarceration before Mac was finally allowed to return home. He returned to find that his family had now shifted to a smaller house, his children were in a public school and his wife was working to keep the home running. Fortunately, Mac had the support of his family. He found a job but soon lost it. He found it difficult to retain a lower level job that paid a fraction of his earlier earnings. He talked too much and worked too little and worst of all, he talked badly about the senior management though he knew nothing about them.

Mac started sleeping – a lot. His wife was exasperated at first but decided to let him be. When he slept continuously for three days, medical help was sought. The pronouncement was Depression. Mac’s condition continued to deteriorate. He slept excessively, ate excessively and cried excessively. He did not want to live, he felt miserable and he could see the financial strain he was causing to the family. Yet, he felt helpless.

The shock of losing his job, status, social standing and finally his lifestyle had proved too much for Mac. His family survived with an internal strength that they had not realized was available to them. But Mac lost his mental bearing. The shock proved too much.

The extent of our personal identification with our successes and failures is directly related to the extent of shock we face in the event of sudden loss. Deborah had no time to steel herself for her loss while Denise did. Mac’s loss was compounded by the shock of deceit and the later realization of lesser value in the workplace.

Talcott attempts to explain the possible pathology that has shock leading to insanity. Physical exertion, excess worry and wine and even excess luxury or poverty can lead to the debility of the nervous system. A weak nervous system is unable to withstand the shock of a sudden event with the consequence of temporary or permanent insanity. Sully explains shock as an extension of surprise or wonder. When an event occurs, the understanding dawns slowly as surprise and in case of an unpleasant occurrence, quickly transforms into fear and shock.

Both on television and in the media, we increasingly witness little girls to be beauty queens before they learned to walk. Some parents have high ambitions for their children. Of course there is a risk that children's own abilities, interests and needs are undermined at the expense of parents' intentions and desires. In working with children and adolescents in the field of mental health, I often encounter children that obviously or implicitly run parental errands. They are in a sense designated as parental delegates, whose purpose is to realize what the parents themselves never achieved, but always dreamed of.

Sancia could sing – beautifully! Her parents and relatives and friends always said that she should be a performer. At the age of 3, Sancia who could barely speak a complete sentence, went on stage and lisped a song solo before a crowd of over a hundred people. Everyone was impressed. ‘Our daughter is going to be a star! Our daughter is going to be world famous!’ her parents spoke about their plans for Sancia. Her mother escorted her to and from myriad classes – music, voice modulation, meditation and piano – all after school hours.

By the time Sancia was 12, there was no doubt about her ability. She opted to participate in a nation-wide hunt for budding talent. It was a hugely successful television show and Sancia, who had won so many prizes, would surely be the chosen one. The competition was tough. For the first time, Sancia felt a flutter in her stomach before she went up on the stage. When she had been younger, it had been different. Her parents had just encouraged her to go and sing. This time, they seemed desperate and tense. Her mother had hugged and kissed her and sent her up with a loving ‘You’ll do it’.

She sang on stage effortlessly and wowed the audiences. But her name did not feature in the final list. Disappointed, Sancia could not stop the tears from streaming down her face. On the drive back home, her parents argued about the choice of dress, the choice of song and the fact that the whole thing could have been done better. ‘It doesn’t matter,’ her mother said as her husband shouted his blame. ‘But we lost the cash prize, see Sancia, we lost the money that could have helped us to make you a big star,’ her father reiterated.

Tired and upset, Sancia went to her room even as her parents continued to fight. She slept soundly that night. She went to the kitchen to find her father alone. ‘Mummy’s left us,’ he announced quietly. ‘See, it was all her fault that you didn’t win yesterday. I’m going to be your manager now. I’m going to make you something. We don’t need her.’

But Sancia did. She loved her mother. Her mother was always nice to her, always there when things went wrong. Her father on the other hand was prone to shouting in the studio, on the stage, in fact, almost anywhere. Why even yesterday, her father had started to fight on the road.

Sancia was scared of her father, though. There was no way of knowing which way he would react. She sat quietly and absorbed the news. Deep within, she felt a huge lump in her throat, a lump that quickly transformed into a flood of tears. It was all her fault. She had not won that was why her mother had had to leave. Sancia’s father watched his daughter’s reaction and tried to explain that everything would be all right, but Sancia wasn’t listening.

Sancia’s mother returned after two days. Now Sancia no longer wanted to participate in singing competitions again. Her mother was disappointed but did not push her. The marriage was under strain and finally broke.

At the age of 20, Sancia was afraid, extremely so, of losing her mother. She was unable to form relationships with other people – they would leave her. Despite her mother’s return after the fight that night, Sancia alternated between hatred against her mother for making her go through the hell of that day and relief that she had returned. Her mother tried to encourage her to turn to playing an instrument for its own sake. She is sorry for the way things turned out after the disastrous television incident and wishes Sancia would put it behind her. But ever since the day she returned home so many years ago, Sancia has blamed herself and her talent for the breakdown of their family. The divorce was acrimonious with her father blaming Sancia for her failure to keep the family together. Sancia agreed with him – thereby making it all the more difficult to adjust to the new life after her father moved out. She is unable to see the inherent weakness of her father as a spouse, a parent and as a talent manager. He had accused Sancia’s mother of being an unwilling participant in developing her talent. An accusation her mother accepted with equanimity. Sancia felt cheated when she understood that her mother had not been keen on making Sancia take the quick ride to success.

Sancia still fears that her mother will disappear one day. She cannot bear to spend a day out of town without her mother. Worse still, she has stopped singing – singing brought bad luck. Her singing was the real cause of her parent’s marriage breaking up. Besides, she isn’t sure if her mother really believes in her talent at all. After all, she had not been keen on making Sancia famous. At times, she regrets the forced flowering of her musical capabilities and its unexpected and sudden demise but feels extremely insecure about getting it back to life again. She makes excuses and vague reasons in her mind to assuage the feelings of regret as they arise. She misses the stage and the applause but will never go back to the old misery; besides, her voice isn’t what it used to be. Sancia is confused about the many cues she has got from her parents. She believes her mother does not believe in her – which is untrue and she believes the accusations her father has leveled at her. Maturity must involve the development of perspective. In Sancia’s case, she has grown up with a sense of insecurity and distrust about the one person who really cares about her.

Talent and competition is a lethal combination. Often, parents see a child’s beauty or talent and decide that it should be put up on display without a thought about the effect of their decision on family dynamics and the child. Putting Sancia on stage without the active support of both parents was a recipe for disaster.

Children are extremely sensitive to their surroundings. Tension, anger, blame for failure, focus on the money that ensues with talent rather than the talent itself leads to misery for the young star and stifles growth of the talent. A singer who is unhappy cannot make her voice follow her command. Talent requires space, unfettered expression, nurturance to remain assured and molding to reach perfection. Parents of talented children would do well to dwell on their personal capacity to ‘manage’ their children’s careers. Some pointers would be:

The child’s talent is not the source of the family’s earnings

The ability to maintain equilibrium regardless of whether the child wins or loses

Strong marital ties and a mutual acceptance that the child’s stars may or may not shine

A search for viable alternatives if the talent does not get the standing it deserves

Normalcy of life to be retained regardless of loss or gain

Resolve possible conflicts about who carries out what role and acceptance of the mutual importance of each person in the family

Families must look within and discuss strategies if they wish to manage talent. The assumption that being a parent makes one a good manager is inherently flawed – the quality of parenting styles is palpable only after the child grows up and faces the world.

In difficult situations we sometimes need a good advice, but all advice is not as good. In this article we investigate the "psychology of good advice". What is the hallmark of a really good advice in a psychological perspective?

The Advice Trap

Often, when placed at a point of confusion or desperation, teenagers feel the need to talk to people and get some helpful advice. How do we gauge the value of the advice? Normally, we place value on the advice on the basis of the value we place on the person. Let us consider what constitutes good advice and the traps that the advice can get you into and methods to weigh whether to follow the advice or not.

The reality is that each person who provides advice does so from a personal context. One person may believe that obedience is necessary regardless of personal choices while another believes that you have to find your way ahead in life. One may suggest keeping up a front that makes you seem successful while another will suggest you should forget about your image and follow your heart. We work out an idea of better and worse on the basis of our own experiences – a factor that can inhibit the ability to explore life’s choices when providing advice.

Gauge the situation

You are planning to do a study course and want to talk to somebody about your choice. Your friends think what you are doing is right because you seem to like the subjects. Your parents do not agree. You are uncertain. Though you had at one time thought that this was the right choice to take, you have started to feel afraid that you will land up with an esoteric specialization that can provide limited jobs. Your parents have expressed the same fear. They would like to see you in steady employment.

What should you do? Go on a fact finding mission to see what job options or further study options can come about through the chosen path. Satisfy yourself that there are ways to work and those methods interest you. Maybe it will take you to different parts of the world and expose you to new cultures. Think about it, picture yourself in that sort of life and imagine the physical and mental stresses. Still like it? You are on the right track. But, what if you like to visit new cultures only when you are with a tour group, are wary of foreigners and not particularly interested in different cultures? It is time for a re-think.

These are clear options. Let us say that you are unable to picture yourself liking or disliking the job options but feel that you should make a choice your parents approve of. This is a time when you feel the need to take advice. If you approach your parents, you know you will receive a perspective in accordance with what they have earlier expressed to you. Your friends will not be able to help you. Who can you take advice from? Ideally, the person you take advice from can provide you a dispassionate and mature view. A person who leaves you feeling less worthy and capable is not a person to turn to. A teacher or any other adult who understands you could be a source of sound advice. You must approach a person for advice with an inherent willingness to listen to what the person has to say but a firm resolve to keep the decision making in your own hands. You cannot at a later date make the claim that you made a wrong choice because of bad advice. This only means that you did not take a conscious decision about your life and chose to follow the words of someone who you could blame.

The main signs of good advice:

Opens up your own feelings to you without making you feel differently about yourself

Seeks to build confidence about your own capabilities

Places responsibility of decision making on you

Refuses to take a decision for you

Rationally brings up your own strengths and weaknesses and focuses on the former

Helps you to identify actions that you can immediately undertake to overcome

Deals with the contradictions regarding your need for approval and desire to follow your heart

Considers the various factors at play – your past academic and experience record, familial factors and constraints, financial freedom and options to fend for yourself and your own feelings regarding the decision

How you should feel after receiving advice:

More decided about making a choice and weighing the contradictions before you

Better able to vision yourself in line with your abilities and talents

Most important, you should feel good about yourself and willing to take responsibility for the choice you take

Traps to avoid:

Emotional blackmail from the person who is providing the advice

Acceptance of responsibility for decision making while the person giving you the advice tries to take the decision for you

Being unaware of the context and knowledge limitations of the advisor

Becoming dependent on the individual who has spent time with you – you are expected to take a decision after possibly one or two more rounds of minor clarification

Viewing the person as someone who can provide perspective on different topics, remember, you are expected to display the capacity to think for yourself

If the advice has left you feeling uncertain or preferring to follow another option with more predictable outcomes, so be it.

A lot of evidence indicates that emotional control and focus on a greater meaning, far beyond one's own personal life and worries, are important aspects of mental balance. In this article we will continue to explore personality development and hopefully gain more insight to the question of mental equilibrium.

In Part I of this article we described the equilibrium as the strength and soundness of a person’s self-esteem. The question is what really characterizes mental equilibrium.So what constitutes equilibrium? Religious texts tell of a few people who had the capacity to hold their own on sheer strength of belief. Jesus Christ and Buddha displayed a high degree of belief in the innate goodness of man. However bad a person’s actions or lowly the background, they were accepted into the fold. Emotional control and focusing on a purpose far beyond the self are important aspects of equilibrium.

If we focus on the personal qualities embedded in these people, we are better able to understand the perspective they wanted to share with mankind. A lesser mind would have baulked at bearing the wrath of the king and an entire populace or leaving the luxuries of royalty to live a life of seclusion. These great beings walked and worked among people who did not at first understand the importance of the message being shared. In times of adversity, these men retained their calm. The calm prevailed and gave them the strength of knowing to forgive the traitor who sat in their midst. There is, then, a superior mental frame at work here. Does this mean that only ‘holy’ men are blessed with the quality of equilibrium?

Inventors, innovators, entrepreneurs and others who follow seemingly impossible or even stupid dreams are examples of people who possess equilibrium. The ability to believe in a dream or larger intent is not within the realm of all people and cannot be understood. The larger group of people may try to bring a person who looks too high or far away to their own level of viewing the world.

The person who retains calm in the face of angry criticism is displaying emotional control. We display equilibrium when we are in control of ourselves in a situation. A fractious child who is distracted into controllable behaviour is being managed with equilibrium. A boss who quietly apprises a team of subordinates of a bad situation is seeking to maintain equilibrium by avoiding an emotional display. A team member may display anger in an effort to get an important point of view across. An angry reaction to a sharp rebuke is an effort to bring equilibrium to a situation. Children may shout back at their angry parents in an effort to voice their view points. Through this emotional outburst, the younger person is trying to bring an internal sense of equilibrium in the face of the strength of parental wrath. The younger person fights back in order to be better equipped to face the conflict. The maintenance of equilibrium does not deter the presence of emotional reactions but equips the person with the strength to remain calm in the face of different forces working simultaneously.

Let us return to the case of Joanna and consider an alternate line of thought (Se previous article, To build a confident personality Part I, for the full story). Joanna is a devout Christian who has considered the tenets of her religion. She is undecided about her path and has considered becoming a nun. Her parents believe she should experience life in its fullness and want her to enjoy life and hopefully settle with down with a suitable person. They feel she is an especially talented person who will not find fulfilment by turning her back on the world. As she goes along, she finds that a lot of people are like her, on a quest of some sort, albeit at different stages of understanding. Some seem oblivious to this while others are acutely aware of it. Joanna decides to take up a job and is easily accepted as a part of the group though there are many who contest her religious leanings. Sometimes she is irritated by their obvious inability to see what is so clear to her. She is undeterred and listens and debates as they try to argue and occasionally denigrate her beliefs. At the workplace, she comes in contact with a colleague who finds ways to unsettle her. Joanna gets to know that this colleague is responsible for presenting false gossip and incorrect facts about her to her superior. She is very hurt and takes a day’s leave. She considers her options and the next day approaches her superior and clarifies the situation without bringing her colleague’s name into it. Later, when she is required to send important information to the same colleague, she does so unhesitatingly.

As time goes by, she realizes she would like to work on helping homeless and abandoned people. She starts to think of ways to make this intent come true. She is contemplating the study of social research so that she can work with agencies that help the people she wants to focus on.

Here we see the forces at work, the family, her personal beliefs and her intrinsic strength. The situations are similar but since she is working on the strength of an internal belief system, she is undeterred and unmotivated by the opinions of people around her. At times, she is rattled but this does not affect the strength of her beliefs.

Now, it is possible to weigh whether Joanna is likely to get cooperation from her colleagues and the thoughts she has about their behaviour towards her. Her professional approach makes it possible for her to change the way her colleagues view her behaviour without her having to say much. Her choices are driven by what she wants to do instead of what a few others think she should do. When faced with conflict, she feels pain but finds effective ways to quickly settle the situation by calm confrontation and exhibiting her focus on a larger purpose. Her capability to consider the larger purpose of the work being done allows her to foster cooperation.

Thus, her mass (mental equilibrium) is determined not by overt signs of confidence but by way of acceptance of her strengths. Situations of conflict and harsh words will and do appear though she prefers to sort herself out before approaching these situations. Another approach could well be an immediate confrontation with the colleague without an emotional display or quietly going about work in a professional manner that displays the falsehood about the rumors that are being spread about her. Sometimes, a short burst of anger helps bring a situation to normalcy. She may choose to adopt this mode if she feels it will alter the situation without making her lose her sense of equanimity. Her choices will be determined by inner acceptance and belief of what she wants to do rather than an effort to impress or please the people in her life.

Identity and identity crises belongs to being human, and especially being human in a post-modern era. In many ways our personality is fashioned in harmony or disharmony with our interpersonal relationships. Who am I, really?

To develop or create an identity is not an easy process. It is not something you can do on your own. Personality is something that matures through social interaction and your sense of self is slowly shaped when you engage in the social games people play. In many ways our personality is fashioned in harmony or disharmony with our interpersonal relationships. When there are many demands calling for our attention, and we feel pressured in many ways, and perhaps some of the requirements are contradictory, it will be extra hard to find our place and act in a way that is most appropriate for ourselves and our social liabilities. In such cases, one must take into account ones true feelings, desires and listen to the inner voice, but again it is not certain that we actually know what we want. Who am I? How did I become me? Can I change? Do I want to change… change into what? In this article we will look at the development of personality and identity. We will also consider some difficulties that might foster a personality disorder or problems in relationships to others.

Kenneth Gergen (1991) is a prominent representative of social constructionism, and he understands the self or personality as socially conditioned. In other words, he believes that human being is entirely a product of social interaction. Professor of Philosophy Dorte Marie Søndergaard (1996) from Denmark takes on a similar approach when she talks about multiple selves. The latter means simply that personality is context dependent and thus altered in different social contexts. Most people will probably recognize themselves in this social theory of individual development. A man is never quite the same at work with his colleges as he is home with his wife, or out partying with friends for that matter. This diversity in our sense of self might sometimes create a kind of identity problem. Who am I, really?

Newton’s second law of motion tells us about the effect of net force on a body. Net force is understood as the sum of all forces acting on a body. Thus, force is equal to the acceleration produced per unit mass. The law goes on to clarify that the higher the mass of the body, the lower is the acceleration. Let us try to view this from the angle of the working of our mental frame. The mass is the core determinant of the effect of random forces that will work on us in this journey of learning. The higher the mass the less is the disturbance on the object from its path.

The object is the individual and the forces acting on the object refer to the impressions of the world at large. Mass refers to the weight of the individual’s view of the self (mental equilibrium) and acceleration is determined by the action of force on the individual.

Complex? Let us clarify this and make it more concrete.

Joanna (the object) comes from a strictly Catholic background. She believes in her innate goodness and tries to live up to this image of herself. At home, Joanna’s belief in herself is reinforced as her family is openly appreciative of everything she does. Her neighbors view her as a ‘good girl’ though she doesn’t have many friends. At work, however, Joanna is seen as a little uppity, unable to get along with co-workers and difficult to get cooperation from. The last time she tried to take a copy of a paper that her boss wanted, the machine did not work. When she asked for help, a few colleagues looked at her blankly and returned to their work. She was delayed at the copier for almost a half hour and her boss was livid. She later understood that a new copier had been placed at the other end of the office and none of her colleagues had bothered to inform her. Joanna states that she doesn’t really care about her colleagues, after all she is there to work for her boss. Secretly, she feels miserable at the work place since she feels that her co-workers gang up on her every time. This is a belief that Joanna has had since the time she was in school.

Joanna has a boyfriend who wishes she would loosen up a bit and hang out with him and his social group. Joanna avoids going but believes this is against her religious tenets and decides against it. She seriously believes she should join a religious order and dedicate her life to God since other people do not relate to her.

We now have a fair idea of the pull and push forces acting on Joanna – her self-image, the expectations of her family and her drive to live up to them, the likely behaviours that she is exhibiting at the work place and with her boyfriend and the feelings generated by these interactions.

Mass is determined by the equilibrium of an individual, as in the value a person places on the self regardless of achievements, statements of acceptance or rejection by others and any other external forces that come into play. The higher the mass of the object, the lesser is the effect of the force.

We are able to gauge that some forces acting on Joanna are likely to be stronger than others. Some forces will be positive to her while some are negative. Her equilibrium will determine her reactions and the direction she moves in.

Now, let us consider a scenario where the forces acting upon her change. Joanna is called in by her boss and given the feedback that there has been a serious complaint about her. She failed to provide timely information to a colleague, which resulted in a customer service delay that was escalated to the head of the company. Joanna starts to explain but is told that her attitude is a cause for concern and she needs to enter a discussion with the HR Manager. Joanna is devastated; she wants to explain how she has been harassed by her colleague. Her superior does not want to know her side of the story and she expects that the HR Manager will not give her a chance to speak either. As she expects, the HR Manager explains the need for building and maintaining a rapport with colleagues and to take a larger view of her actions.

Joanna meets her boyfriend whose immediate response is, “Obviously they don’t like you! You believe you are walking a few feet above the ground, but haven’t any achievements to show for it. Huh! If you were so great you would be somewhere else, not working as a customer service flunky.”

Joanna is stung. Her boyfriend proceeds to tell her he wants some time to reconsider their relationship. “I don’t know if I can have a long term relationship with someone who wants to be a nun and believes that this makes her superior to everyone else. You ought to check what attitudes religion recommends.”

Now, we see the action of forces working on Joanna’s ‘mass’. When she returns home and recounts the events to her family, they rally around her. Her strong need for acceptance is satisfied by her family. The extent of equilibrium determines whether she analyses why she is facing unpleasantness in the workplace and choose remedies or chooses to blame her colleagues and the entire company as unfair. It determines for her whether she needs to consider changes within her behavior repertoire or continue as she has in the past and change the circumstances by finding a new job.

The stronger a person’s beliefs about the self the better able are they to adapt to new situations. One person may lose his job and turn to alcoholism while another takes it as a learning and chooses a new line of business or a new way of working. The first displays signs of low equilibrium while the latter is the opposite.

Emotional and mental equilibrium is something we earn if we dare to look at our own faults and examine the situations where we run into conflict with other people. To look for errors in others are generally not a constructive strategy, even though the counterpart may have the main responsibility for the conflict at hand. It is only our own reaction we have the possibility and ability to adjust. If we can encounter people with openness, avoid aggressive or passive aggressive behaviour, try to control our automatic defence strategies when we feel pressured and take lessons from problematic events, rather than ending up in bitterness, we can call ourselves psychologically wise or emotionally intelligent. People with this kind of abilities rarely end up in conflicts and they usually have a high degree of satisfaction in life. They also have a superior psychological equilibrium (a solid mass, i.e. solid confidence) that makes them resistant and able to handle strong forces that affect them without losing its steady course through life.

We will continue this discussion and the story of Joanna in Part II: To build a confident personality Part II: “A lot of evidence indicates that emotional control and focus on a greater meaning, far beyond one’s own personal life and worries, are important aspects of mental balance. In this article we will continue to explore personality development and hopefully gain more insight to the question of mental equilibrium”. Read more

What is insanity and what is normality? Often we understand insanity as the opposite of rationality. Here we meet Sophiya. She is an accomplished consultant, but when she loses her job, she also “loses herself”. What happens? We will try to take a closer look at the border between mental illness and good mental health.

Sophiya is a bright executive – reliable, competent, smart. Her only problem is her continuing need to bring up the flaws of her colleagues in front of their bosses. When confronted, she replies simply, ‘I was merely voicing my opinion’. Before long, most of her colleagues (including the managers) dislike her. A slip-up on a project is attributed to her and she finds herself with no friends. At a high-powered meeting, she casually refers to a minor error made by a senior manager in the company. ‘I was merely using the event as an example,’ she said when asked about why she had brought it up. One day, she is asked to leave the company.

Bewildered and angry, she puts up a fight. ‘Why has everyone turned against me? They are jealous because I am so good at my work. How can they tell me to quit?’ She finds no support from her co-workers and returns home, heartbroken and forlorn. Her husband, always aloof, takes in the news of the lost job without a flicker of emotion. He finds her emotional outbursts a massive disruption to his work as a researcher. He shrugs his shoulders and says, ‘If you want to, you should find another job or you can wait till the kids grow older and go to work again.’ Sophiya is adamant; she craves recognition for her efforts. At home, she is nobody but at the workplace her personality transforms, people ask about her, people in high positions depend on her – she is important. She is someone.

She starts her job search and is disappointed to find that the recent recession has left companies unwilling to recruit more people. Days turn to months and Sophiya feels more and more isolated. Her children go to school but need her attention for a few hours before they get busy with their homework and friends. Her husband is away at work from morning to night and likes to have the weekends with the kids. They plan outings but Sophiya feels separate, alone. They have lunch together and Sophiya feels that everyone has a reason to laugh except herself. Her husband recommends a few internet sites that will allow her to connect with old colleagues and friends. She goes online and soon finds people she knows who welcome her into their fold.

But something is wrong!

Sophiya accepts a few strangers as friends and is shocked to receive abusive messages coming her way. Upset, Sophiya logs off. ‘Why did this stranger insult me like this?’

She talks about it with her husband and he shouts, ‘We tell our children to be responsible about strangers and an adult is behaving like this!’

A few days later, she joins some of her ex-colleagues in online banter, she smiles at the ongoing exchange when she suddenly goes cold within. ‘These people are making fun of me – the meaning behind that statement was a barb at me.’ As Sophiya watches the exchange, she comes to the chilling conclusion that she is actually going through a set of coded messages – all the messages are barbs at her and one or two threaten public exposure and shame for her. Public exposure about what, she wonders. What have I done that I should get this type of treatment?’

In a sweat, Sophiya calls up Ruby, one of the people who is online and asks, ‘What did you mean by that last comment?’

Surprised, Ruby browses through the chat messages and replies, ‘Oh you mean the one about the clothes? That was a joke in reference to our last picnic, remember? The time when we had gone to the beach and Jed had worn floral pants…’ Ruby laughs as she recalls the time.

At the end of the call, Sophiya is convinced that Ruby is part of a conspiracy against her. The joke about the clothes was a statement about her personal style or something, that detail is fuzzy. In a panic, she calls up her sister. Her sister is not home. Sophiya starts to weep bitterly as she holds the receiver. She breathes deeply and suddenly becomes aware that someone else is listening in on her calls. Unable to fathom that the sound of breathing is her own, she drops the phone and runs to her bedroom and locks herself in. The conspirers have now started tapping her phone! That would have to mean they knew when she lifted the phone, which meant that they were watching her every move.

She pleads loudly, ‘What can I do? I’m innocent. I haven’t done anything wrong. I have always spoken my mind, always spoken the truth. Why is this happening to me? Mercy is after me. She is behind this. She has ganged up with Raoul and is actively trying to spread rumours about me. They are doing this because…’

The phone rings and Sophiya jumps in fright. She refuses to budge from her room afraid that someone has heard her or worse… she’s fuzzy about what that could be.

What is happening to Sophiya?

Thinking is a necessary cranial function. Our five senses are constantly alert to changes in our surroundings and relay messages to our spine and brain to allow for appropriate reaction. But what if the brain gets into a mode of excessive thought? Excessive thought that distorts perception and leads to a different view of the happenings around us. When thought is excessively focused on a single thing – like death, fear, suicide, sex, love, illness – we see manifestations of an uncontrolled mind. When perception is warped to a point that a person feels alone, endangered and unnecessary fear ; it is seen as a sign of insanity.

Is there something inherently wrong with Sophiya?

Thought mishaps happen to all of us. Sophiya does not deserve this and neither should this be written off as some unknown inherent problem. Sophiya craves attention – she derives a sense of identity with it. This is quite similar to the identity that people place with being married or having a partner or friend or money or status – there is no inherent right or wrong.

In the case of a jilted lover, the mind is maddened by feelings about and images of the person who has caused the pain. In the case of a missed prize and adulation, the mind is filled with justifications of how one is ‘actually’ better than the prize winner and is overwhelmed by pain and jealousy. Painful events and wrought emotions are numerous – hind sight tells us whether we were temporarily insane at that time.

Sophiya’s first need is attention. Now to a lot of us, attention involves hearing a person out, being there, listening. In Sophiya’s case, if her husband tries to engage in conversation, it will set the existing thought cycles in motion and Sophiya will speak incessantly without saying anything new.

There is an alternative form of attention – that of giving a person some concrete responsibility to handle and recognizing the work done. Sophiya’s sense of identity comes from her work, she likes being looked up to, needed and noticed. She would like to be the ‘belle of the ball’ while utilizing her own set of skills.

If Sophiya is a good cook, she can hold cooking classes. This work will keep her gainfully employed and keep her at the center of a group of listeners. If she likes to teach she can help kids with their studies. The essence is to find the talent that is within the person and allow its expression. This form of attention will go a long way in helping Sophiya to manage the self-hurting thought cycle that has set in place.

A disinterested spouse who finds himself trapped in a dramatic marriage must reconsider his priorities. The children must be involved in helping her back to normalcy. The family may well take professional help to identify the right way to help Sophiya. Professional help and family support can go a long way in helping her to find her way back to living, albeit with a new career. Left to herself, Sophiya is unlikely to find a suitable solution. Displays of anger and irritation at her odd behavior will only make her feel increasingly isolated and accelerate the descent into uncontrolled thinking and insanity.

There are many mental disorders that involve our inability to assess instant gratification in contrast to long-term consequences. This article is about impulsivity versus reflection and planning in relation to drug abuse and addiction.

One of the fundamental and insidious problems with substance abuse is the horizon problem. This is the common inability among humans to see the results of immediate gratification in the long view. The horizon is too far away. It is easy to ignore.

The list of chronic conditions that share this mechanism is long and many come to mind: overeating and obesity, sedentary lifestyles; even behaviors like chronic financial mismanagement fit this paradigm. It seems as if evolution has wired us for near-term outcomes.

Evolutionary Advantages

Edgar Rice Burroughs wrote a series of excellent novels about Tarzan, a human being raised among the great apes. Tarzan gained a few supra-human abilities from his simian upbringing — he retained many of the primitive skills that modern men underutilize. He was extremely agile, strong, and had keen, animal-like senses. Beyond this, Burroughs wrote about an ability that gave Tarzan extraordinary speed. It was the simple notion that Tarzan could act without thinking. He could do something instinctively, while his opponents were still considering action. This highlights a key evolutionary concept — the advantage of instantaneous action over consideration and planning.

In an environment where the immediate surroundings are flexible and fraught with danger, prompt action is a survival trait. Not only do the strong survive, but the quick also. To breed tomorrow, we must survive this day’s challenge, and not only this day’s, but this minute’s and this second’s threat.

Enter consciousness. While all animals can be said to have instinctual behavior and immediate reactions to at least some stimuli, man has planning and imagination tacked on. The more we are able to control our environment in the long-term, the less we have to rely on emergency action. Our decisions today can make tomorrow a better (and safer) place to live. The evolutionary advantage of quick response is partly supplanted by the advantage of hypothesis about the future and actions directed toward achieving it.

Unfortunately for mankind, the near-term is still with us. If it feels good, do it.

Solving the Horizon Problem

Social scientists and psychologists have come up with at least one method to address the horizon problem.

Because the problem revolves around an inability to make future adverse consequences as ‘real’ as present benefits, the idea is to bring the distant horizon closer. If you want to save money, but find it impossible to make an envisioned bank balance impact spending right now, move the act of saving closer to the temptation to spend.

In drug abuse prevention, this is used to link consequences to the gratification. Public Service ads – “This is your brain on drugs” – showing adverse effects try to highlight near-term consequences. These only work if the imagery is both powerful and retained. It is doubtful that someone at the point of lighting a crack pipe has a television commercial in mind.

Medically, addicts can be prescribed drugs that change the effect of their preferred substance. The oldest in use is Disulfiram – which blocks the metabolism of alcohol and ruins the experience. The breakdown of alcohol is modified so that acetone builds up in the body. Alcoholics know that drinking while taking Disulfiram will make them sick. Sick is good. Sick is an immediate consequence. (See: http://www.cochrane.org/reviews/en/ab007024.html for a meta-study on the use of Disulfiram for cocaine addiction.)

Varenicline, a nicotine receptor partial agonist, is used to treat smoking addiction with the same principle in mind – remove the near horizon benefits. For opiate addiction, Naltrexone can be prescribed (an opioid antagonist).

Problems remain. Addicts must be relied upon to regularly take the preventative medications. Some (Naltrexone) are available as subcutaneous implants to overcome this deficit. None are ‘cures’.

Difficulties

A major problem with trying to bring the long-term results of addiction closer to the drug taking event is that the brains of addicts are reshaped by the addiction process. A loss of normal dopamine metabolism means their ability to respond to normal (no drug) pleasurable events is impaired. In a sense, homeostasis for this population includes taking drugs. Anhedonia is the unwelcome result of abstinence.

The brain changes in response to repeated exposure to the addictive substance. D2 receptor activity and number decrease over time with cocaine, amphetamines, alcohol and heroin. Worse than this, changes in memory and learning that are linked to ‘reward circuits’ mean other stimuli, not directly involving drugs can induce craving and compulsion long after active addiction has ceased.

Addicts will often describe how a certain lighting or other seemingly unimportant environmental cue can trigger a strong desire for ‘their drug’. We have known since Pavlov how deeply ingrained behavioral training can be, and while more complex with humans, the ideas remain parallel.

Time and Impulse

Near and far horizons have to do with time. Ask any addict to reflect on the results of their addiction and they will agree it is a terrible curse. None will recommend addiction to a loved one. Across long scales, we are very good at seeing the damage. When the impulse to use arises, time is different. Suddenly, the past and the future disappear and there is only the immediate now – a now full of craving and need.

One way to fight addiction is to address this short-term crisis. If an addict can be saved from the immediate situation, the behavior may be prevented. They can overcome the impulse if it can be stretched out in time, allowing better judgment and rationality to intervene. This is why supervision and incarceration work. Addicts are physically prevented from using and the urges get somewhat weaker with each cycle of impulse and denial. When supervision or incarceration ends, the behavior is free to reemerge.

What is needed is training that allows for self-supervision. It is possible to learn how to get past the stimulus-response impulse by time-shifting. This method is similar to that used to control other impulse based conditions – “I’ll wait to gamble until this weekend.” There is a chain of behavior that can be short circuited if it can be delayed.

In the end, the horizon problem is best handled by either moving long-term repercussions closer to the act or by time-shifting the act farther from immediate payoff. Neither is easy to accomplish, but both have had some success modifying other behaviors.

Many people are controlled by their emotions, whether they realize it or not. Emotions have of course a function, but all too often we think that emotions are telling us the truth about ourselves and the world. So it is not. Emotions can trigger thoughts that further influence our actions. Sudden impulses and unpredictable emotions can thus have far too much influence; if we do not rally acknowledge that we are not our emotions.

How many kinds of emotions are there?

Apart from specialists in the field, the average person might perhaps take a hazardous guess of close to 20 or 30 emotions with which we commonly associate. Did you know that there are as many as 90 definitions of emotions? – as disclosed by Robert Plutchik in his American Scientist article entitled “The Nature of Emotions”.

In his book, The Power of Now, Eckhart Tolle defines emotion as “our body’s reaction to our mind” in amplified thought pattern(s) that consist of energy that is overpowering (pg 22, 36). Plutchik likens them to “feedback processes”.

Imagine this — the workaholic mind pottering away incessantly – fueled by its depository of past personal circumstances / experiences as well as things or experiences it desires in the future. Atop that, pepper in stealth emotions that have, knowingly or unknowingly, been on the simmer; then, factor in the limitations of language and one has at hand, the ingredients for one’s emotional cocktail mix of the day. Knowing this information, 90 is very plausible.

The Plutchik’s Wheel of Emotion provides the names of some of the more primary emotion dimensions

A basic underlying emotion – Fear

Fears are emotions that occur in response to threats that are real or imagined, mind-perceived ones. In the former case, think of extreme sports like free-fall parachuting or rock climbing from which most would instinctively coil. The latter consists of psychological mind-perceived fears such as worry, anxiety, tension, nervousness, depression, addiction, and phobia, which are much more complex to unseat. Oftentimes unless their underlying problems are accurately defined, their solutions are often hit-or-miss, deluding their seekers’ of tangible answers.

Tolle mentions that psychological fear is fear that is not associated with any real immediate risk but one which constitutes a “part of our basic underlying emotional pain” (pg 35). Emotional pain arises from very human false self or ego-manifested time-related “anxiety gaps”. They often revolve around worrying over the lack of — money, cars, clothes, recognition, status, love, happiness, self-esteem; bitterness over life circumstances, how they wish it had been better; what they wish they had done or not done, and the list goes on. There is a lot more going on behind these scenes, e.g. the ego, the pain-body etc, to be explored in future articles, with Eckhart’s help.

How to tune in and stay in balance?

Can we control our emotions? Would it not be great to be able to access the anxiety off/on button to switch off the source that feeds one’s many insatiable wanting? No more worries and stress over things, circumstances, people but instead right to baby mode i.e. just with basic needs to be fed, washed, clothed, groomed, attended to and put to bed. Improbable as it may sound, to one’s inherent mind -filled and –controlled person, it is very doable.

Babies with their wide-eyed and wholesome manners, are always stress-free and operate very much in the present moment all of the time. In nature’s animal s kingdom, squirrels, deer, bears, tigers, lions etc gather / munch / hunt when hungry, eat, sleep and then wander around with hardly any stress apart from when predators or hunters pursue them. Thus, they live in the moment too, but can gear into action should danger arise.

Spiritual teachers and leaders alike, do not seem bothered with their lack of belongings or things. They involve themselves in relieving the stresses of the world but they themselves seem psychologically unaffected by the physical and mental suffering they try to relieve. Although the doctrines they follow differ, a common characteristic seems to be a call for the stilling of, the almost round-the-clock on-the-job minds of their followers, through prayer, meditation, chanting, and the like.

Despite the many challenging poses and sequences in various branches of yoga, its practitioners seem to be able to do them with great ease. The underlying formula to doing the poses is just to be mindful, and, present in the moment. To start, beginners will learn to relax and quiet the mind by purposefully paying attention to each inhale and exhale of their breath. Their practitioners will agree the minute they let their minds take charge,is when their poses or sequences go awry.

Take charge or take back charge of your life

In the Internet age and its ubiquitous presence, it is harder to switch off the dysfunctional needy mind but Eckhart Tolle has given his readers many simple and practical ways in which to do so, a few of which are mentioned here. Firstly, he suggests that one pays attention and observe the emotions in oneself as oppose to watching others. For example, if Molly has an argument with husband Jack, she should not focus her attention on what his demeanor is but rather, to watch her own manner in the episode.

Secondly, to learn to accept the “is-ness” or the current condition, state or circumstance, as it is, without fretting over why it should not be this way. Accept it for what it is and then take whatever action is necessary. Let’s say, Jane is about to lose her home or job because of the recession, she should accept that which is happening and take actions appropriate to salvaging from the circumstances. Stressing and worrying over it equates to wanting things to be different i.e. non-acceptance of the now situation. In fact, by being present and connected with what is, she will tap into even more creative ways to handle the situation.
Although time is factored into human lives for practical purposes, the dysfunctional mind is solely time-related and always flip-flops between clinging to the remorse, anger, annoyance, happiness of the past, or, the anticipation or apprehension about the future. That is how it sustains itself. Each moment the dysfunctional mind is forced to be in the now, depletes it of control over the person, while transmuting that power or energy to the deeper essence or being within.

One will know how and if these techniques work by putting them to the test. It takes practice to un-train old traits but if done correctly and consistently, one will shift from merely existing and surviving life, to, embracing and living life in all the brilliance it has to offer.

Eckhart Tolle tells us how incessant and often disturbing thought patterns bungle our minds and prevent us to live more consciously. Then he explains how emotions reinforces negative thoughts and occupying too much mental energy thus wasted on unnecessary “mental noise” ad destructive emotions. By reading Tolle’s teachings, one realizes that it is often practical and prudent to act on our thoughts, but other times it is enough just to accept, recognize and observe the thoughts going through our minds without buying into them or act. This insight is valuable, especially for a western mind, which all too often loses his temper in traffic.

Emotion and thinking

In his book “The Power of Now” (ed 2005), Eckhart Tolle writes about how incessant and often dysfunctional thinking, clouds our minds and prevents us from living more consciously (pg 12). He goes on to define how emotions are “amplified and energized thought pattern(s)” that consist of energy that is overpowering (pg 22). They tend to go hand in hand and have a way of feeding each other that can be self-destructive.

Many, in general, would hardly view emotions and thinking as being harmful or even self-destructive. Is that not part of our in-built system upon which we primarily rely on to survive and function in this world? Upon further reading into Tolle’s teachings, one realizes that at certain times, it is sensible and practical to act on one’s thoughts but at other points, it is enough to just accept, recognize and observe without buying into them. Many famous athletes, who win championship after championship despite seemingly insurmountable odds, often refer to how they did it by staying focused and “in the zone” i.e. by being mindful and aware of what is happening as oppose to reacting to mind-filled pressures.

Out of the zone

Some practical examples to which one might relate Tolle’s teachings are deliberated next. How often has one witnessed, or contributed to, road rage and other forms of dangerous driving? Many drivers will agree they have their fair share of blame, perhaps brought on by lack of sleep; unfamiliarity with roads, careless or incompetent driving, running late, and the list goes on. The topic of dangerous driving is an area to which almost everyone can relate, be it to a greater or lesser degree. Can one perhaps learn from these potentially harmful and negative experiences on another level?

Imagine this incident, whereby one is driving along a two-lane one-way road, with an SUV in the left lane, moving along a little haphazardly. Then, somewhere along that stretch of road, a Mercedes Benz joins in on the right lane. The SUV driver happens to be talking on his cell-phone and with only one hand at the wheel, his car veers into the right lane now and again, much to the consternation of the Mercedes driver. Before you know it, they slide down their windows and accusing fingers are a’waving at each other with hinted threats of “I am going to ram into you”. Rising tension and explosive emotions emanates from the side-by-side vehicles. Fortunately, for themselves and other users on that road, at the next T-junction, they take different routes.

Another category of equally prevalent road incidences are those associated with drunken driving or speed racing after a night out, wherein drivers are not in control of their senses. A dare here and a challenge there, egged on by their well-meaning but equally drunk companions, before you know it, they will be ramming their feet at the pedals and sealing their fates. Many a heart-wrenching stories have occurred because of such decisions, where those responsible were disconnected (even for split seconds) with their conscious mind.

The trauma thereafter may bring untold stress, injury and disruption not just to the lives of the victims but to all who are near and dear to them as well. A worst case scenario would be where they go from comatose into semi-vegetative states of limited cognitive function i.e. severely diminished awareness and abilities to recognize, perceive, reason, and to judge, requiring round-the-clock specialized care. Consequently, many lives become forever changed. Although too late in the day to ask, but, at the same time one wonders if given a second chance, what could have been done different to save the day?

What if?

Let us ponder a few questions here, with the help of Eckhart’s teachings :

With reference to the first, suppose the Mercedes driver just kept a safe distance, noting the SUV’s license plates, and simply passing that along to the police. Would that not have saved him a lot of needless angst? His actions are however quite understandable, being a citizen of this fast paced world — where one can quickly and independently get things done with “a click of a button” – the reactive reflex action to want to teach the SUV driver a good lesson right now instantly kicks in, naturally and sometimes, dangerously so.

Where drunken driving is concerned, if drivers were to take just a few precious seconds to weigh out the state they are in; be more aware of what they are getting themselves into; and, instead of engaging their clouded emotions, to just let them “fall by the way-side”, they will be acting with their very best interests at heart.

Get in and stay in the zone with Eckhart Tolle´s philosophy

Are we our minds? If we are, why would we put ourselves in harm’s way as in the above examples? Is the mind not the very tool we rely on, day in and out, to survive and thrive in the world? Does it actually have flaws and dysfunctions, to which one might be oblivious? How does one ensure it functions in a way that nurtures us as oppose to forsake us? If given the choice, would human beings allow themselves to be enslaved to a tool that is flawed? How can we take charge and be in the driving seat instead?

Human beings are magnificent creations in itself, whose physical, mental and psychological make-up have been, and continue to be, scrutinized, dissected and analyzed. Why not befriend and extend the magnificence that is within? Eckhart Tolle, through his own awakening, shares the answers to the above questions and more. One has to read, understand, and practice his philosophy in order to experience the shift that will unseat the archaic thinking to which we have been inaccurately accustomed to i.e. that we are our minds. It is miraculous how one can move into the underlying realm of truth so simply, and to live our true lives, fearlessly. The reason why his philosophy resonates and reverberates so strongly, all around the world, is because it speaks a universal truth, which just touches lives, regardless of race, religion and culture.

Eckhart Tolle is certainly a remarkable man. In this video he is talking about handling anger and destructive thoughts to live more freely.

The biological models for understanding drug abuse focus on organic brain changes due to substance abuse, and how this fosters an adjustment to the drug and further causes a physical dependence. The psychosocial theories have an emphasis on drugs as a way to cope with feelings and psychological discomfort. Is it two irreconcilable perspectives, or may be different perspectives can complement each other to help us understand the depth and complexity of drug abuse and addiction? One trend is abundantly clear however: No longer is addiction seen as a disease of the will or a moral imperfection.

Abuse of naturally occurring and human-modified substances dates at least as far back as the discovery of alcohol through fermentation. While it is uncertain just when alcohol was first used, current evidence dates it as long ago as 10,000 BC. In more modern times, Dr. Benjamin Rush (often called the father of psychiatry) mentions addiction to alcohol in his 1812 treatise, Medical Inquiries and Observations upon the Diseases of the Mind and calls it a “disease of the will”. Ideas about addiction, its causes and treatments have changed substantially since then – Dr. Rush’s mainstay treatment was bloodletting and ‘sweat therapy’. In spite of this, addiction remains a complex disease with no clear cure.

Definitions

In current medical practice, definition often equates to treatment, so understanding just what addiction refers to is important. Unfortunately, there is no one definition that captures what it means to be addicted in every case. For this reason, it has become a matter of picking off a list of symptoms – more than a set number of these (usually 3 or more from a list of 7 in a 12-month period).

(Note: in this list, sometimes a behavior is under consideration rather than a substance – this covers the usage of the word when applied to shopping, gambling or other process addictions.[modified from addiction and recovery. org])

Tolerance – the phenomenon of increased substance use to obtain a similar effect.

Withdrawal – physical or mental symptoms that occur primarily from the removal of the substance. For drug abuse, this and tolerance have well understood physiological mechanisms.

The substance is taken over longer periods and in larger amounts than intended. This automatic ratcheting up of dosage is marked in illegal drug abuse.

A persistent desire and lack of success in attempts to lessen use. Short term abstinence will be followed by usage that quickly returns to pre-abstinence norms and above. This, along with number 3 is felt by patients as a spiraling loss of control.

A great deal of time is spent in obtaining, using or recovering from the effects of the addictive substance.

Activities that are seen as important are sacrificed because of drug use. These can be work related, personal goals, recreational or social. Combined with number 5, the experience is that the substance begins to ‘take over my life’.

Use is continued despite the knowledge that it is harmful, either physically, psychologically or socially.

Withdrawal and Tolerance

While the psychosocial aspects of addiction are still being clarified, the phenomena of tolerance and withdrawal are comparatively well understood. The most accepted model is that of receptor site changes, over time, in the addicted patient.

Dispositional tolerance has to do with less of the additive substance reaching the active site. This can happen when a person becomes more efficient at metabolizing the drug. For example, if the enzymes for detoxifying a substance are up-regulated in the liver, first-pass metabolism is increased, reducing the amount of active substance more quickly than in a naïve patient. Giving a competitive agonist (naloxone for opiates) will also produce dispositional tolerance, because the agent blocks the active site and prevents binding of the abused drug.

Tolerance also occurs by cellular mechanisms. By decreasing the number of receptors (down-regulation) for a particular substance, cells mute the effects. Another cellular mechanism is a feedback response to whatever neurotransmitter the drug is increasing. The baseline for the neurotransmitter (either secondary to substance administration or because the substance itself mimics a neurotransmitter) is elevated and the normal production is reduced.

Finally, cellular mechanisms may be responsible for increasing the removal of either the drug or consequential neurotransmitters – making the body more efficient at removal, which presents as tolerance.

Withdrawal is a playing out of the consequences of tolerance. The body has modified its way of doing business and set a new level of homeostasis. In effect, the abused substance has become part of this new ‘normal’. Removing the substance results in a sometimes overwhelming (and perhaps fatal) suite of symptoms that can be thought of as a ‘negative overdose’. All of the physical changes that led to tolerance now require the drug for the body to operate properly.

It should be emphasized that tolerance and withdrawal happen pharmacologically with many drugs at therapeutic doses. Weaning is a common technique to avoid withdrawal in such mundane drug classes as steroids and anti-depressants.

Psychosocial Aspects

Beyond the physiology of addiction, there are the real psychological and social harms that occur. These are now seen as having almost as much weight in the addiction process as the pharmacological effects. The reason for this is the high rate of recidivism among drug users who have undergone treatment and have been abstinent for months or even years. The actual substance has long disappeared from their system, yet users may still return to their drug of choice.

Psychosocial mechanisms also may help explain why someone abuses a drug in the first place. No physical addiction mechanism can account for man’s propensity to seek out ways to alter our own mental state.

The broadest definition of addiction treats it as a biopsychosociological phenomenon. The bio part covers evidence that genetics probably has a large role in both who become addicted and how deep the addiction will become. One trend is abundantly clear however. No longer is addiction seen as it was in Dr. Rush’s day – a disease of the will or a moral imperfection. Rather, while society at large may still stereotype addicts as failed human beings (in both the moral and character sense), medical professionals see more clearly the underlying disease process.

Angels, yoga, tarot cards & crystals characterize the great packaging, but Ken Wilber believes that the appealing surface of the new age movement conceals both narcissism and magical thinking. Are there any dangers in the metaphysical funfairs?

Magical Thinking: Ken Wilber’s Cautions about the New Age Movement

It’s like jumping inside a living fairy tale–metaphysical fairs, ear candling, crystal healings, the pretty, Medieval inspired costumes and the many faces of the Tarot deck. There is a harmless, innocent regression in the service of the ego when enjoying some of the pastimes of the New Age Movement. These are fantastically appealing methods of both entertainment and in some cases, personal healing. However, the philosopher Ken Wilber sees past the pretty packaging and identifies the dangers that lurk in magical thinking and the presumption that our thoughts can create reality.

Magical thinking in a psychoanalytic sense is of course the belief that one is the center of the Universe. It is desirable in children while they are being raised up and nurtured but profoundly dangerous in adults. It is a derangement of normal narcissism that is transitory in most people when they are at their happiest and their saddest. It is the same narcissism that marks the “King Baby” notion of Bill Williams, originator of Alcoholics Anonymous. It is the essence of selfishness and can, when held to absolutely, cause psychotic states. It is the keynote of Borderline Personality Disorder, the foundation of that disorder’s ability to be at times grandiose and at times utterly contrite for actions good and bad that reach well beyond that individual’s capacities.(1)

Wilber is concerned by a trend in magical thinking in New Age culture since it derails true meditation and true enlightenment by devolving into narcissistic thinking. The notion that the Universe starts with me and ends with me can be comforting, but the loss of perspective and narcissistic encapsulation blinds one to the gloriously complex matrix we are a part of. Magical thinking induces a loss of humility because it fails to recognize hierarchy. Wilber issues strong cautions against this relativity, its lack of scientific rigor as well as its lack of moral compass.

I believe that the hyper-individualistic culture in America, which reached its zenith in the “me decade”, fostered regression to magical and narcissistic levels. I believe…that the breakdown of more socially cohesive structures turned individuals back on their own resources, and this also helped reactivate narcissistic tendencies. And I believe, with clinical psychologists, that lurking right beneath the surface of narcissism is rage, particularly but not solely expressed in the belief: “I don’t want to hurt you, I love you; but disagree with me and you will get an illness that will kill you. Agree with me, agree that you can create your own reality, and you will get better, you will live.” This has no basis in the world’s great mystical traditions; it has it basis in narcissistic and borderline pathology….”(2)

This is the dark side of what Wilber calls “boomeritis”—that which ails those of us who are part of the proverbial Baby Boomer Generation.(3) This egocentrism, narcissistic encapsulation– whatever words one uses to describe the focus on the importance of self–this is the common cold of us Boomers. Because of its childishness, it can certainly be comical in adults and one is reminded of the character Stuart Smalley, a 12-Step devotee (and professional victim) with a fictional talk show, featured on the American television program, Saturday Night Live.(3) Wilber’s book is replete with the many character manifestations of this sensibility and he presents one such, a professor giving a lecture attended by the book’s protagonist. This professor is issuing a clarion call that now is the time for the greatest level of understanding ever, the greatest synthesis, and that true enlightenment is about to happen due to the spiritual readiness of the current generation. And he bottom-lines this amazing moment of opportunity—

“…many eggs were broken to make this extraordinary world omelet.”(4)

Some have criticized Wilber’s book, a radical departure from his previous work, as an uneasy pastiche of rollicking satire interspersed with his more characteristic hierarchical theorizing. Irrespective of the concern for its fictional merit, it could certainly be argued that Wilber chose to use humor and fictionalized case examples to drive his point home in this case—as his work has, by his own admission, become highly abstract, complex and is easily misunderstood.

In one way, Wilber proposes that an understanding and appreciation of hierarchy is the antidote to boomeritis. Rather than everything being equal in value and reducible along a flat continuum, there is an inherent hierarchy along which all building blocks of matter and consciousness are arrayed. Also, Wilber maintains that all the wisdom traditions of humankind have in common a “perennial philosophy” which recognizes this hierarchy.

Central to the perennial philosophy isthe notion of the Great Chain of Being. …reality is composed of several different but continuous dimensions. Manifest reality, that is, consists of different grades or levels, reaching from the lowest and most dense and least conscious to the highest and most subtle and most conscious. At one end of this continuum of being or spectrum of consciousness is what we in the West would call “matter” or the insentient and the nonconscious, and at the other end is “spirit” or “godhead” or the “superconscious” (which is also said to be the all-pervading ground of the entire sequence, as we will see).

The central claim of the perennial philosophy is that men and women can grow and develop (or evolve) all the way up the hierarchy to Spirit itself, therein torealize a “supreme identity” with Godhead--the ens perfectissimum toward which all growth and evolution yearns.(5)

Thus, Wilber’s argument against the New Age could be stated this way: it seeks tolerance through an abdication from dialectic. Everything is “okay” because everything is relative. Let’s face it–dialectic is tiring, argument is confrontational and appraisal is inherently an act of judging. Rather than run these risks, it is easier to think magically—but far more dangerous.

Have you ever wondered why happiness is so elusive and no-matter how much you zip around, work and accumulate things; happiness always seems to be unattainable. Even if we do manage to feel happy; it is only momentarily and before we know it we find ourselves down in the doldrums of fear, doubt and anxiety once again. So what is the key to lasting happiness? Is it achievable in a lifetime? Is it necessary for us to spend a decade in the monasteries in Tibet or the ashrams in India?

The full story

The ego fabricates stories in order to keep us a step away from being happy and at peace. The non-verbal scheme of the ego includes convincing us that we will attain happiness and peace in the future when we get “this” or achieve “that”. It also tries to sell us the idea that we can not be at peace because of something that has transpired and therefore cannot be changed.

True happiness and deep peace has everything to do with embracing reality – the moment of Now. This is what Buddha called the “suchness of life” and opposition to this “suchness” or “IS-ness” is the the primary function of the ego. A plethora of various forms of psychological suffering begin to crop up when the ego succeeds in displacing the mind from its throne – the present moment – doing this is what fuels the ego which then creates more suffering and negativity. It’s a deadly downward spiral and almost all of us are trapped in it. The ego operates from behind the curtains and its primary strategy is always to keep its host oblivious to the tricks its pulling on us. Think for a second and ask yourself; how many times have you observed people doing exactly what they condemn others for doing? How many times have you tried to point that out but have only been met with denial, clever justifications, anger and tricky arguments? On a grander scale; have you noticed that this phenomenon is not only limited to individuals –it applies to groups, political parties, religions, governments and corporations alike?

To put an end to this vicious cycle of perpetuated unhappiness, you have to take total responsibility of what is going on within NOW – forget about everything else and simply ask yourself, “what am I feeling NOW” then be totally attentive and become aware of the negativity/unhappiness within you – also notice the voices that justify this unhappiness. Awareness equals psychological freedom and unawareness equals rigid identification with thoughts and emotions. Not being aware of the mechanics of your inner state is like falling asleep while driving at high speeds – becoming aware gives you the power to retake responsibility and to choose happiness and peace over the vicious control dramas of the ego. Freedom from the ego is not something that will happen in the “future”, its “now”. To quote Eckhart Tolle, “You cannot find yourself in the past or future. The only place where you can find yourself in the NOW. Spiritual seekers look for self realization or enlightenment in the future. To be a seeker implies that you need the future. If this is what you believe, it becomes true for you. You will need time until you realize that you don’t need time to be who you are.” 1

The core of the ego and it’s cunning devices

Fear and greed-based thoughts disguised as “self” is at the very core of what ego is – this is the mind made “me” which is always looking for ways (real or imagined) by which it can be “more” – this also explains the ego’s insane addiction to the future. This also explains why the ego is hell-bent on looking at the present moment simply as a means to an end – and when the end is achieved the ego comes up with another end… The ego habitually uses the tools of separation and conflict to enhance its image and to strengthen its identity (this is the “us” vs. “them” syndrome). Statements such as “believers vs non-believers” are now almost cliches – haven’t we all seen nations, religions, corporations and tribes draw their sense of identity by opposing another group of people? Food for thought: who would the believers be without the non-believers?

The value in being self-aware and in the “Now”

Being compassionately aware of this trickery will trigger the dawn of a deeper, indestructible, un-attached and peaceful presence which can loosely be called the higher Self. This awareness is free from the trappings of the external world. Its far more intelligent. Its joy is unconditional. Its peace is deep and ever-lasting.

Operate from this level of self awareness while going about your day to day activities and drop the idea of using the present moment as a means to an end. Make the “doing” more important than the expected results of the “doing”. The future never arrives – our lives are always NOW. Living in this way means that you have accepted the suchness of life and have understood the futility in arguing with whatever arises in the present moment.

“I am not my thoughts, emotions, sense perceptions, and experiences. I am not the content of my life. I am Life. I am the space in which all things happen. I am consciousness. I am the Now. I Am.” 2 – Eckhart Tolle.

Arriving at the truth by peeling away all falsities

It is definitely worth pointing out that a real spiritual teacher will not be interested in selling you his beliefs, rules, intellectual theories and ideas. Because the real essence of happiness (and even spirituality) has nothing to do with thoughts, words and huge fortresses of beliefs and opinions; but it has everything to do with the formless, ever-present, impartial, and still truth withing you. Therefore the job of the spiritual person is not to add onto your existing thoughts, beliefs and opinions; but rather, to remove all falsities that separate you from that truth within – actually coming to this inner truth (as opposed to only intellectualizing about it) is what brings deep inner peace and true joy and happiness.

However, words have their role to play as well. Words are capable of pointing one towards the divine stillness and truth within – like signposts point us towards our geographic destinations. But beware of the fatal mistake of confusing the signposts for the destination. Unlike ordinary thoughts and words which say “look at me”; truth-bearing thoughts and words will always imply, “look beyond me”.The destination is, always has been and always will be, within us.

In the words of Eckhart Tolle, “Most people spend their entire life imprisoned within the confines of their own thoughts. They never go beyond a narrow, mind-made, personalized sense of self that is conditioned by the past. In you, as in each human being, there is a dimension of consciousness far deeper than thought. It is the very essence of who you are. We may call it presence, awareness, the unconditioned consciousness. In the ancient teachings, it is the Christ within, or your Buddha nature.Finding that dimension frees you and the world from the suffering you inflict on yourself and others when the mind-made “little me” is all you know and runs your life. Love, joy, creative expansion, and lasting inner peace cannot come into your life except through that unconditioned dimension of consciousness.” 3

Eckhart Tolle is basically a “spiritual advisor” who currently has little influence on Western psychology. Yet his Eastern-inspired philosophy of life is an important supplement to the mental health profession, and many of his books are important tools in terms of self-development and mental balance. Today psychology begins to get inspiration from several of the great wisdom traditions, and Tolles philosophy is perhaps crucial for the modern human who suffer from stress, worries, spinning thoughts, mental noise, high standards of efficiency and little knowledge about the real joy of life.

What exactly is the ego? The Eastern wisdom traditions assume that the ego is a mental construct that constantly need confirmation in order to feel whole and valuable. Most people identify with a little ego that strives for status, material goods, more money or other things to assert itself. Strong identification with material belongings, physical attributes, status, power, wealth, or lack thereof; or even a mental position – “I am right” – is the ego at work. Ego leads you away from the moment, looking for intended happiness in the future, but during this persistent hike, you may miss out on life itself. Can we free ourselves form the destructive forces in ego?

Facets of mr/ms/mrs Ego

Can you tell what kind of ego you have? Do all humans have it? Do we need it to survive and thrive in this world? Are we born with it and how does it evolve over time?

If one pays attention – be it at work, school, college, out shopping, at the movies, on vacation — one will easily catch glimpses of the ego in others. And, with practice and open-mindedness, it will be easy to recognize it in oneself. The ego covers the spectrum from that of the all-puffed up, glaringly loud ones to those who cower and cringe from the lack of self-esteem and lots of varying versions in between them.

In ordinary terms, ego is defined as “one’s image of oneself”, “inflated feeling of pride in your superiority to others” and “consciousness of your own identity”.

One will instantly recognize it in feuding parties, phrases like, “Let me show him who calls the shots”; “No one will ever get away with double crossing me that way again!” or “So they think I am not good enough for their company, let me teach them a thing or two.”. Then there are situations where one person “feels unworthy of another’s company because I am not pretty enough, not good enough”.

They tend to either express the speaker’s inflated feelings of superiority or deflated feelings of inferiority, and both stem from the egoic mind. The truth is we become what we think. So, if we think we are superior to our fellow beings, we self-crown ourselves as such, but, that crown will easily be toppled when others see through the perceived façade that the mind wants to possess. In the process, however, there might be untold damage that will arise before the truth emerges.

Digging into ego`s roots

Everyone comes into this world as infants with clean slates. This slate then gets written on by one’s nurturers – usually parents to begin with, then family, relatives, friends, peers, etc throughout one’s formative years. He or she is instilled with their values and principles, which have in turn been molded by their personal experiences – at the familial, cultural and societal levels. In turn, the value systems they hold, stem from beliefs and practices of their individual and collective, physical, thinking world.

In his book, “A New Earth”, Eckhart Tolle talks about how a child starts to identify themselves with their own names, then with who their parents are and then their toys i.e. “this is my mommy, my daddy, my teddy”. Young children often get defensive when another child plays with one of their toys, they get worked up and obsess about wanting to play with that very same toy.

As one grows up, the identification with toys is replaced by humans clinging or obsessing with how educated, wealthy, powerful, famous they are. Tolle refers to the ego as the “false self” – “false” because human beings perceive their worth or value primarily on the narrow basis of their physical, materialistic lives. This is no fault of the individual as that has been the way it was, throughout the centuries and continues to be, in the human, thinking and unconscious world. This suits the ego perfectly as it gets full control over the mind, to the exclusion of total consciousness, in which spirituality abounds.

Analogies

Let’s delve into a few practical analogies to shed light on Eckhart’s teachings. So, e.g. Adam, who has been brought up by his drunken and abusive dad, perceives that his dysfunctional past has been the root cause of the majority of his life failings. Whenever he is unsuccessful at anything, he feels dejected and mentally regurgitates on the bad cards he has been dealt with, in his life.

His all-consuming ego stokes the fire that keeps his past circumstances, very much alive, albeit in his mind. Although there is nothing he can do about what is essentially history, little does he realize that his ego is happily sapping away his energy from tapping into the depth of his creative being. If only he was aware that the thinking mind is but only a fraction of his total consciousness.

Then there is Fred, who although faced with similar life challenges, does not delve into debilitating mind games of his past. Instead, he accepts his failure, directs his energy at capitalizing on the lessons learnt and seeks out possibilities, even from his fallen stance. He neither strongly identifies with his past nor his previous failures. He does not allow the time-locked ego distract him from what is at hand and what needs to be actioned.

What happens when one is freed from Ego`s hold?

In 2008, well-known US talk show host Oprah Winfrey hosted a global webcast seminar with Eckhart Tolle, for her book club selection and his book, “A New Earth”. They discussed the book at length, as well as answered questions from callers, the world over. In it, he made the thought provoking remark that if enlightenment was according to one’s material belongings, then the world would have reached enlightenment (many times over) with its deluge of shopping malls. One can sense that in fact, the world is far from being joy-filled in the truest sense; psychological suffering is far from being diminished.

Strong identification with material belongings, physical attributes, status, power, wealth, or lack thereof; or even a mental position – “I am right” – is the ego at work. One can strive towards a more comfortable lifestyle or state one’s viewpoint clearly but one need not latch on to them for dear life, wherein it takes over one’s being.

Whether it is a life challenge, an investigation, an experiment, or a questionnaire, if it is based on inaccurate evidence, the results will be flawed. Similarly, if one run their lives based on illusional ‘facts’, they would be operating at sub-standard levels, thus depriving themselves the opportunity of living the essence of who they are, and which life openly offers.

Eckhart invites all to learn to recognize the illusions that the ego often creates in order to be able to reduce the damage it is capable of creating. Just the act of recognizing it will lead to its eventual exposition and to the surface, the reality, miracle and depth of who we truly are (p 28). It is as simple as that.

Many of our thoughts are automatic and often repeat themselves without our conscious influence. It creates mental noise and causes distress and depression according to Eckhart Tolle. What then, is the key to mental balance? Well, a number of outstanding professionals claim that openness and attention is the key to freedom of spinning thoughts and existential anxiety.

Mental static and the rise of “I”

It’s worth noticing that the majority of our thoughts are automatic and repetitive – it almost seems as if thinking happens to us; rather than us actually thinking. This is what’s loosely termed as “compulsive thinking” and if we observe ourselves (and others) closely enough, we would immediately notice that we are seduced by this mental static – we march around, meeting people, getting things done and acquiring things as if our peace of mind and happiness depended on it. But has acquiring things, earning recognition and scaling the power hierarchies ever rewarded anyone with lasting happiness? Our history books, story books and religious scriptures are brimming with metaphoric and literal arguments against the idea of attaching peace of mind and happiness with the material world – yet we still somehow cannot stop ourselves from being constantly seduced by our automatic and repititive thoughts that which demand that we run faster and faster on the treadmill of life.

Our mistake seems to stem from the fact that we identify ourselves with our minds and the noise that our minds create – we confuse the “possessor” with the “possessed”. This is the birth of what is called “ego” – a false self which is a very pale substitute of the real self. The weight or thickness of the ego (false self) is directly proportional to the degree to which we identify with it. Hence, the amount of suffering we go through is directly proportionate to the weight and thickness of our ego. Its worth noting that our consciousness is far wider, deeper and vaster than our day-to-day mental static; but by being scammed into believing that we “are” the static; we open the floodgates to all sorts of psychological and spiritual dysfunctions.

The thickness and density of the ego differs from person to person and from time to time. Where some people are always trapped in the control dramas of their egos; others enjoy brief periods of freedom – this is when they are being creative or engaging in self-less acts of sharing and giving. Those who are permanent prisoners of their own out-of-control minds are, in essence, cut-off from their very own true self and; as a result, these people will usually come off as fake. As a way forward, these people should start off with making a genuine attempt to be more aware of their chattering minds and its seductive trance on them – this self awareness will pay rich dividends in bouts of mental peace as it will begin to awaken the still, calm, silent, deep and compassionate consciousness that’s all encompassing enough to drown out the noise of the ego. This all encompassing consciousness is the real Self.
This is how Eckhart Tolle describes this phenomenon, “You are cut off from Being(the all encompassing real Self) as long as your mind takes up all your attention. When this happens – and it happens continuously for most people… The mind absorbs all your consciousness and transforms it into mind stuff. You cannot stop thinking. Compulsive thinking has become a collective disease. Your whole sense of who you are is then derived from mind activity. Your identity, as it is no longer rooted in Being, becomes a vulnerable and ever-needy mental construct, which creates fear as the predominant underlying emotion”. 1

Understanding the mechanism of emotions

Now that we have some insight into how the our mental chatter gets entangled with a false sense of “self” to give rise to the ego; its also important to understand that emotions are triggered when the body reacts to this mental chatter.
The body operates and is regulated by its own organizing intelligence. This is the same organizing intelligence that perfectly and independently regulates the blood flow, the digestive system and the respiratory system. This is also the same organizing intelligence that immediately switches the body to “fight or flight” mode by infusing it with unbounded energy in the face of immediate danger – as a result one would feel fear, anger and a possible plethora of other primordial responses. These are prime examples of the body reacting to immediate threats in the “external environment” by temporarily taking over complete control. This is what can loosely be called the body’s instinctive response.
But, on the other hand, an “emotion” is the body’s reaction to a “thought” (and not to an immediate external threat). The body cannot distinguish between a thought (mental static) and a real, physical threat. So, you could be sitting in the comfort of your drawing room and thinking fear-based thoughts; but your palms will begin to get sweaty, your heart will beat faster and your muscles will tense-up as if the threat is real and in the physical environment. The bad news is that since the perceived threat is only because of mental chatter, the built-up of energy in the body has no means of release and therefore gets pent up in the body and turns toxic – this then causes an imbalance in the smooth and natural functioning of the body. Result: disease, sickness and chronic ailments galore.
Just as the ego strengthen itself by investing the mental chatter with a sense of Self (the “I am the noise in my head” syndrome); it also strengthens itself by identifying with unexamined emotions. At times the mind will think a though, the body will react in the form of an emotion and the emotion will trigger a response so fast that the conscious mind will not even be able to process what’s going on. This “thought-emotion-reaction” cycle tends to be so quick, unconscious and automatic because of a person’s repeated and dense past conditioning. Haven’t we all met people who would adamantly always act and behave as if everyone is untrustworthy or as if they don’t deserve love, prosperity and happiness?

Regaining control; shattering the vicious cycle

The only way to break this downward spiral of negativity is to become aware of the negative thoughts, emotions and corresponding reactions as much as possible. When an emotion is triggered, try to trace that emotion to it’s reactions in your body – these bodily reactions/sensations/impulses could be anything from harsh to subtle. The trick is to use the light of self awareness to completely feel these emotions in your body with an attitude of total acceptance – having an accepting and open attitude is the key to dissolving any chronic negative emotions. If you find it difficult to feel these emotions in your body then try to practice conscious breathing – feel the air entering and escaping your body for a few minutes before slowly and steadily turning your attention towards the body and its subtleties. Keep an open and yielding mind and quietly accept all emotions of guilt, anger, fear, unease, anxiety and grief etc as and when they arise – no resistance. Carry this process of “feeling-and-accepting” into your day-to-day life and a time will come when the all encompassing true self will begin to emerge and dwarf the egoic mind – this true self is deep, silent, compassionate and indestructible. In the words of Eckhart Tolle, “Surrender, one could say, is the inner transition from resistance to acceptance, from “no” to “yes.” When you surrender, your sense of self shifts from being identified with a reaction or mental judgment to being the space around the reaction or judgment. It is a shift from identification with form–the thought or the emotion–to being and recognizing yourself as that which has no form–spacious awareness. Whatever you accept completely will take you to peace” 2

Fear in the face of danger is of course a normal reaction. But when we react with fear in situations that are not really dangerous, we sometimes call it anxiety. In a sense, anxiety is fear gone astray. Phobia is another word for misplaced fear. Phobia is an irrational, intense and persistent fear of certain situations, activities, objects, animals or people. The main symptom of this disorder is the excessive and unreasonable desire to avoid what we fear. There are many different phobias, but the theory that will be explored in this article suggests that each phobia is a combination of five underlying fears.

The sensation of fear is one we all know: ‘butterflies’ in the stomach, dry mouth, sweaty palms, dizziness, shortness of breath, stammering, and the inability to think clearly. This response is automatic and hard to overcome, especially when each individual exposure to the stimulus you fear strengthens the response.

Understanding where fear comes from is an interesting pursuit, and the theory that will be explored in this piece suggests that each phobia is a combination of five underlying fears. Consider these in a similar sense to each flavour being made of five underlying tastes: sweet, salty, bitter, sour and umami. The proposed underlying fears are:

Mutilation: fear of losing or sustaining damage to any part of your body, internal or external

Separation: fear of being abandoned or rejected, or a perceived loss of personal worth

Ego-death: fear of loss of integrity of the self, either through humiliation, shame, or feelings of worthlessness

Extinction: fear of ceasing to exist (most commonly described as a fear of dying)

Loss of autonomy: fear of being restricted in some way, either temporarily (trapped) or permanently (paralysed)

Breaking down some of the most common fears in terms of the ones outlined above is an interesting way to understand the impact they have on us. Below are the three of the top fears felt by the US public, and some thoughts on their composition:

Spiders

Arachnophobia is well known, and malevolent spiders feature in many fantasy novels (Harry Potter’s Aragog and Lord of the Rings’ Shelob immediately spring to mind). This phobia represents a combination of fears of mutilation and, depending on the severity, of extinction.

While some spiders are poisonous, the level of exposure to these in day-to-day life is very low compared to the prevalence of the fear. The evolutionary argument suggests that fear of spiders is an artefact from when they were more of a risk to survival, but there is also the belief that the fear is only widespread because it is passed around easily on a societal level (for example between children and parents).

Death

Despite macho claims, this has undoubtedly entered everybody’s mind at least once. What happens after death? Is there an afterlife? These are both questions best answered elsewhere, but the sense of unease you feel when considering them points at the common underlying fear of dying.

When you break this fear down in terms of the five fears outlined above, it obviously best represents a fear of extinction. Often, depending on the views and other fears of the person, it will be paired to one or more of the others: being buried alive, for example, is a combination of fear of loss of autonomy and ultimately of extinction.

Being a failure

This represents a mixture of fear of separation and ego-death. It is the root of many fears including public speaking, performance, and being the centre of attention. The evolutionary argument suggests that in social groups earlier in history, making a big deal of yourself and attracting attention may have resulted in problems or increased your risk of conflict, so people evolved to learn to be wary.

Often there is a discrepancy between peoples’ perception of you versus your own, so often thoughts of being a failure are often not manifest in others.

So, does knowledge of how fears work help us to reduce the hold they have on us? The NHS webpage on fighting your fears details ten methods people can use to tackle day-to-day fears, and ‘Get real’ is on the list. It says that “fears tend to be much worse than reality” and that by remembering that the response is normal and the threat is usually not as severe as the perception, you can reduce their effect.

Understanding the composition of your fears can help you to address each part individually, too. If you know that fear of spiders is commonly passed between parents and children, you can investigate whether your fear has tangible roots or whether it is just habit. This may be the prompt you need to realise that you’re not actually as afraid as you thought you were.

The main symptoms of depression are loss of interest and lack of energy. Other symptoms may include feelings of guilt, inferiority or decreased self-esteem, suicidal thoughts, difficulty concentrating, restlessness, agitation, sleep disturbances, loss of appetite or weight loss. The incidence of depression has increased in recent decades. Around 25% of women and 15% of men will experience depression requiring treatment during their lifetime. If you recognize any of the signs of depression listed in this article, it is important to look at the possibility for help or self-help as soon as possible.

Ups and downs are part and parcel of life and relate to every living soul. There are times when the downs persist, giving you so much emptiness and despair that just doesn’t seem to go away. In such cases, chances are that you have depression and the condition makes it difficult for you to function normally and enjoy a healthy, productive lifestyle. The burden weighs heavily on your faculties and can sometimes be overwhelming. The greatest need in such a scenario is to know that you can get better and all it takes to deal with the issue is recognizing its symptoms and knowing the causes as well as the available treatments. Hence, it is important to act now to treat depression before it is too late, if you notice any of the symptoms.

What is Depression?

Depression is often misunderstood by most people to relate to the normal feelings of drowsiness and sadness that occur in response to disappointments, setbacks and the everyday struggles of life. Real depression amounts to something much more than sadness; some have described it as being akin to living in a black hole or having an apocalyptic feeling. What makes it improper to associate depression with sadness is the fact that not everyone feels sad. Rather a great number of people afflicted with depression experience feelings of emptiness, lifelessness, and apathy. For the menfolk this may be actually worse with symptoms such as restlessness, anger, and aggressiveness.

Depression takes a hold on every aspect of life and can disrupt everyday activities such as work, sleep, and eating. People suffering from depression will tell you of a nagging feeling of hopelessness, helplessness, and worthlessness that runs deep and shows no signs of abating.

The Signs and Symptoms of Depression

Although depression affects different people differently, there are some common indicators that point towards the existence of depression. Once again, it is important to be able to make a distinction between the lows of everyday life and real depression. The trick is to see how many of the depression symptoms are manifesting themselves and the length of time that they last . The more symptoms you have and the lengthier the times they manifest mean you are possibly suffering from depression

Some of the common symptoms include:

Loss of interest in day to day activities

Self-loathing

Loss of energy

Reckless behavior

Concentration problems

Feeling hopeless and helpless

Unexplained aches and pains

Anger or irritability

Appetite and/or weight changes

Do you have problems getting sleep or maybe sleep excessively?

Do you experience enduring feelings of hopelessness and/or helplessness?

Are you having issues with your concentration and finding it difficult to execute simple tasks?

Have you developed a poor appetite or maybe have suddenly turned into a food conveyor belt?

Are you having a tough time getting a hold on your negative thoughts despite your best efforts?

Do you find yourself being more short-tempered, irritable and aggressive than usual?

Have you suddenly developed a penchant for a reckless lifestyle or consuming more and more quantities of alcohol than previously?

Do you suddenly consider life as not being worth living?

Answer These Questions for a Quick Check

Do you have problems getting sleep or maybe sleep excessively?

Do you experience enduring feelings of hopelessness and/or helplessness?

Are you having issues with your concentration and finding it difficult to execute simple tasks?

Have you developed a poor appetite or maybe have suddenly turned into a food conveyor belt?

Are you having a tough time getting a hold on your negative thoughts despite your best efforts?

Do you find yourself being more short-tempered, irritable and aggressive than usual?

Have you suddenly developed a penchant for a reckless lifestyle or consuming more and more quantities of alcohol than previously?

Do you suddenly consider life as not being worth living?

The Way Forward

If you suspect you or a loved one is going through depression, it is important to seek professional help without any delay. It is not unknown for depressed people to take regrettable decisions such as attempting or committing suicide. It is also important to seek counselling if you have just had experiences that can affect your ability to function normally.

When you recall the past, the resident memories carry the emotional content of the moment. A tremendous exercise in control is required to isolate the event from the emotion. Some are trapped in the past in a way that previous trauma prevents personal growth and development, but when all is said and done, we can to some extent affect the way we interpret our past and then be the author of our future. We must accept the painful memories as part of our personal history, and then make sure the bad memories do not prevent us from living here and now. This is sometimes a difficult task.

Sandy sat quietly in the car with her husband on her way back from a party. “When we were to be engaged you said you weren’t sure if you were willing to commit,” she said suddenly. Her husband frowned in reflection and admitted, “Yes, that is right, I felt that way then.”

“How could you allow yourself to get engaged to me without being sure of what you wanted?” she continued, her voice breaking as tears started to stream down her face. Her husband, Andrew, sighed as he readied himself for the “how could you…” argument for the nth time. He is getting tired of this behavior that his wife adopts so often. He has seen her whip herself into a frenzy of “how could you- you don’t care” to an extent that he has started doubting her sanity. The problem with her line of fighting is that he is unable to provide an explanation. He admits to having been stupidly honest in the past, at that time he had thought she would understand.

They have been married for the last five years and have two children. When she and her spouse fight, all the statements, angry comments and past hurts are re-created leaving both of them hurting and exhausted. At times, Sandy feels she has been hurt so much that she needs to leave the relationship. Her husband feels the same way. The children are the deterrent. At moments of normalcy, the couple is loving and genuinely caring. Though, there is no way of knowing when the next flare-up will occur. Sandy and her husband have tried to retain their calm, for the sake of the children, but they continue to fail. The slightest mistake, facial expression or exclamation is enough reason for the next fight and raking up of the past. Criticism, cruel words and hurtful intent fill the communication. In the recent past, Sandy rushed at her husband and struck him and was stunned when he struck her back. They decided to put the past behind as both repented and resented the fight. Until now…

Her husband has started to feel victimized and has created a repertoire of memories that he can hit Sandy back with – measure for measure. He doesn’t feel satisfied with this route of action but it makes Sandy quiet and gives him the feeling of having won, temporarily at least. The couple feels victimized and acts in ways that are contrary to their true feelings about each other. The children for their part feel that the best way to stop fights is by crying inconsolably until the parents kiss and make up in front of them.

Two people who have been in a relationship for any amount of time will have moments of error. If the relationship is genuine in moments of normalcy, there is scope for retaining and improving it.

Re-creating the past

Remember how you felt when your best friend cheated you or a parent wrongly castigated you? When you lose a loved one, the memory of the funeral will inevitably bring tears to your eyes, as it did on that day in the past. When you recall the past, the resident memories carry the emotional content of the moment. A tremendous exercise in control is required to isolate the event from the emotion. This is the reason why Sandy and her husband are having a problem. If they look at their relationship from a long-term perspective, they prefer to stay together. Neither of them likes the idea of being separated though they have seriously started contemplating the possibility now. Would they like to try to stay together? They must confirm that they want to try to stay on as a couple because they have added some valuable learning to each other.

Some of us tend to stay in past hurts, holding grudges against friends for events of our childhood and adolescence. The person we hate goes ahead with life, finds happiness and contentment and probably forgets us completely while we are stuck in a quagmire of hatred. It is necessary to recognize this self-limiting style of thought.

Sandy’s marriage is reaching a state of irreparable damage due this habitual line of thought and argument. Andrew has, in the recent past, considered divorce but is afraid of losing custody of the kids. He knows Sandy will die if the children are taken away from her. He does not want to do that to her, but he cannot continue like this.

Confront the past

Situations of this sort require third party help since both the warring partners are unable to come out of the turmoil. Sandy and her husband will have to come to terms with their pasts. Sandy’s insecurity stems from her fear that her spouse does not care about her and may leave. Andrew cares but does not like to be blackmailed into saying so. Yes, he was in a state of uncertainty about the commitment. He remained so until he saw his first baby and it dawned on him how much he loved Sandy and re-affirmed his decision about getting married. He hates the idea of breaking up a marriage, he sees himself as a one-woman man.

Face reality

In the course of a marriage, there are times when the relationship feels ambiguous. The transition from single to double to family places the adult into a variety of new, if temporary roles. At times, the pressure can be too much. The past cannot be changed or undone. A fight about such an event will lead to no avail. This is the reality. Andrew and Sandy must view their marriage as valuable with or without the children and act accordingly. Andrew has probably been unthinking about his confessions in the past while Sandy has been hurt and kept mum. A repeated action or statement brings back the hurt and Sandy reacts while Andrew is stunned at the force of the reaction. Both are victimized.

Value the present moment

Sandy and Andrew will have to commit to letting go of the past. They will need to decide to be happy for their own sakes instead of feeling that the marriage hinges on the presence of the children. An effective behavior to be adopted if either party brings up past issues is to identify the behavior, “You are dwelling on what is past, we have both had good times and bad. Control your behavior.” This brings Sandy back to a conscious affirmation of her intent and slowly helps her to reduce and control her mind when it starts suggesting possibilities that she fears. It prevents the fight from escalating into an uncontrollable event.

Accept the problem

Sandy needs to accept that this thinking line stems from a flawed reaction to a perceived crisis. There is strength in clearing the air when she does not like something Andrew says rather than keeping it in her mind for later reaction.

Trust and distrust often represents a difficult dilemma. Trust fosters confidence, while distrust can ruin a good relationship, but we can`t always trust our children? The question is when can and should we actually trust our children and give them freedom and responsibility, and when should we act as mentors and provide guidelines and restrictions? The troubles of being a parent.

Parents often make the matter of fact comment, “I can’t trust my kid…” and expect that the object of their distrust will grow up with a sense of confidence and trust in the parent. This is a mistake. Depending on the stage of growth at which your child is, you must determine the points at which you can trust them to be independent and points at which you cannot trust them to take care of themselves.

Moments at which distrust, or more appropriately extra care, are required:

Leaving your child with a stranger or another family member

Letting your child cross the street alone

Leaving your child free in a zoo or a large fair

These are some situations in which your child may not be aware of the possible dangers and act wrongly. In these cases, you are not showing distrust to your child. You are assessing the situation holistically and combining your awareness of your child’s abilities before taking a decision. If the child is below five, you will not allow independence in the above situations whereas you may be open if your child is a pre-teen.

Moments at which you may leave a small child’s side:

Birthday party

Sending the child for a school picnic

Permitting an outing with friends and a parent

You may be wary if your child is very small and will allay your fears by ascertaining the arrangements for the care of children. Safety precautions and suitable care by adults help you to satisfy yourself towards an appropriate decision.

Often when parents make the statement about distrust, they are referring to the innocence of the child and the possible dangers the child would face. There must be a distinction between the fear of childish innocence and distrust. Keeping the channels of communication continuously open can mold childish innocence in a fruitful direction.

Distrust, on the other hand, is akin to suspicion and fosters a feeling that all people are to be regarded with suspicion. Distrust presupposes mala-fide intent on the part of the younger mind and draws conclusions on the basis of action instead of open communication. Distrusting your child does little by way of nurturing them or making them aware of the realities of the world outside of home. In fact, it reduces their sense of self and comes in the way of maturing and managing situations independently and effectively. Your distrust in them begets their distrust in you.

A parent who communicates expectations to the child and is consistent about the downside of not living up to expectations can expect that the communication will not be taken seriously. For instance, you may tell your child never to go to a friend’s house without informing you beforehand. Your communication also needs to cover what is expected in a situation of having to hurry to the friend’s home and difficulty in contacting you. It is possible the friend wants your child to go out to the store, tell your child what is expected. Your child is expected to inform you and take care to avoid certain things. In case of the real possibility of not being able to contact you in the face of an urgency of going elsewhere, what should be done? Who should be informed? Make sure your communication is clear so that even if your child is unable to call you, he or she is aware of what timely action to take. Since you have kept your child informed about different strategies to be adopted, you know that there is a little leeway you can provide. This is a method of building trust between you and your child.

A parent who does little more than insisting on the expectation of being called and restricts the child once the call is made is giving the message of distrust – distrust does not receive respect, it receives disobedience. Do not allow your worry for the child to lead to disregard of preferences. Under circumstances of normalcy, you need to develop a set of actions that you can expect the child to remember and consciously adhere to.

Going out with friends

When a young child is going out with friends, there may be situations that lead to inappropriate behavior. You may feel that your child is with the wrong group of children. Counter this effect by reiterating your trust in your child and guiding thought towards identifying the difference between right and wrong, acceptable and unacceptable. Highlight your expectation that your child will use certain ground rules, for instance, causing hurt to another person or property is not ‘fun’. In the face of goading to do a daring act that has the capacity to kill or maim, it is better to dare to do something to good effect. One can dare to be risk-taking in business or finding creative ways to manage situations and help people.

You can clearly put into a young mind the expectation that restraint is to be exercised before being a part of an activity. If you find that this is not happening, the effect of the peer group is greater than your own words, take stronger measures. Let your child know that you are watching out for any behaviour mismanagement that can cause trouble to the family or the young person. Highlight to your child the difficulties that children of that age face by references to current happenings and the impact on their own lives and their families.

Trust denotes the expectation that a person will take responsibility for actions and use judgment in the face of doubt.

Vera was neglected as a child. She grew up, married and had to kids. In her marriage she behaves badly, as if she would like to be abandoned and disliked so the story of her past can repeat itself. To change her life, Vera has to forgive the past, and then she has to forgive herself before she can reinvent her life. Forgiving doesn't mean forgetting, nor does it mean that you've given the message that what someone did was okay. It just means that you've let go of the anger or guilt towards someone, or towards yourself.

Gandhi famously said, “The weak can never forgive. Forgiveness is the attribute of the strong.” Holy books, religious texts and scores of literature dwell on the nature of forgiving. How does it feel to do so? Vera should be able to guide you through. She has been through a difficult childhood and adulthood. She is able to dwell on the past without being bogged down by it and feeling hurt.

No doubt this makes the angry resentful mind squirm but a life-threatening disease and a family crisis brought Vera to a search for forgiveness.

Vera’s father died shortly after her birth – tuberculosis, they said. Her mother lacked the funds to care for her and sent the baby to her brother’s home to stay. Vera was unwelcome from the start. She was five when she was given food and made to sit separate from the rest of the family. By the age of ten, she was being beaten severely for the slightest infraction. The girl fared poorly at school and longed to return to her mother.

One day, when Vera was 13 years old, she ran away. Her mother stayed in a ramshackle house and did not appear healthy. She was not in a position to care for her daughter though she knew of the ill-treatment the child was facing. Vera begged her mother to let her stay but her mother was adamant. She could not keep her daughter safely in this place, she argued. Frustrated by her mother’s refusal to keep her and angry with herself for having bothered at all, Vera returned to her uncle’s house. Her uncle had informed the police about her loss and was relieved to know that she was alive though not pleased to see her back. Vera was not happy to be back and seriously contemplated suicide. Something held her back. Her mother died soon afterwards.

Vera married a good man at the age of 25. She had two children and all seemed well, though she was given to bouts of anger and viciousness. The beatings and continued ranting towards the children led to the belief that Vera was mentally unhinged. Her husband’s mother was called in to help Vera take care of the children. Her husband was a mild mannered person and found her behavior quite bewildering. Vera seemed to be particularly hateful of her daughter, the younger of the two children. With her husband out of the house for most of the day, Vera seemed to take great delight in following her daughter around the house and lampooning for imagined mistakes. She would beat the child at the first instance she got.

One day, there was a call from the school and Vera went over to know what was wrong. Her daughter, all of six, had thrashed a child of three in the playground. The girl’s parents wanted the child to be counseled. At the counseling session, it transpired that the child viewed her mother as hateful while she liked her grandmother, father and brother. The elder child concurred that the mother was too harsh and ‘not nice’. Vera had not anticipated the feedback and was stunned by the reaction of her children.

Her husband decided to keep the children away from their mother and filed for divorce. Vera could not fathom the speed with which she was being abandoned once again. She wept and pleaded to be allowed to stay with her family, but her husband was adamant. At this point, Vera was diagnosed with progressive heart disease. Her husband continued to press for a divorce despite her condition though he was financially supportive.

She entered therapy and chose to spend long hours in solitude. She joined a group in the course of her therapy in which she vented her ire against the family that had abandoned her. At first, the hatred she felt towards her uncle and his family and her feelings of pain about her own family overwhelmed her. She resented her husband and children for throwing her out and blamed her husband for being uncaring. She turned to religion for succor but found no peace. Finally, it was her mother-in-law who sat her down and helped her. She explained how things happened to her when she was a child and not in control of the situation. The absence of love at a young age had left her wanting it and not knowing how to get it. She was able to provide a mature and calming perspective that Vera had never received in all the years.

This approach acted as a catalyst for Vera as she realized how she had blamed everyone around her instead of appreciating what they had given her.

Emotional control

First, Vera was taught to stop herself when she was angry. She learnt to stop and check what her real feelings were. Vera realized that when something irritated her, she ceased to think. She felt things were going out of her control and used physical means to control the situation. It was a long while before she realized how alone she was since people were repelled by her behavior. Her husband had not reacted in time and taken a final step when it got too much to bear.

Forgive the past

Sometimes, things happen without being anyone’s fault. Vera’s parents were unable to care for her. Her mother chose to send her to the relatively safe environment of an uncle who was not willing to feed an extra person. Each person had a distinct context for their behavior. Nobody was evil in their intent; they were worried about their own. Vera realized how difficult her own behavior must have made it for her uncle to let her stay in the house. After initial reactions of hatred against her family, she started to realize how the events had unfolded. She saw the times when kindness and love had helped her, though she had failed to see it given her mental state.

Forgive yourself

This is the most difficult action. Explaining her childhood was relatively easy, the difficulty lay in her acceptance that she had bullied her spouse and children and had in fact behaved abominably drove her to a state of depression. She realized that her husband had disliked her as had her children. She slowly realized how her acceptance of her errors had gone a long way in improving her self-awareness and control.

The return

She was allowed to visit the children and slowly realized how loving and lovable they were. She wept bitterly as she remembered the hurt she had caused when they were younger. They were young and more willing to forgive. Her husband was wary of letting Vera back into his life again. She realized that she had hurt him deeply and that he did not trust her. She stopped trying to get him back and relaxed into accepting her single status. Her mother-in-law gives her regular updates about the children and she is in touch with them on chat and with regular visits. She is aware that as they enter their teens, she will have to face their ire about her past behavior, possibly see the same behavior she exhibited with them.

Health

Her physical health may never recover completely. The stress has been high. But, Vera is now a happier and more fulfilled woman. Better able to accept the vagaries of life and appreciate the good.

Negative emotions cloud out perspective and bring in a state of self-doubt. A daunting wall of apprehension, disgust, and self-hate is formed and stands in the way of the ability to look at life with a positive mind. This is a story about loss of confidence and low self-esteem.

“If a man does not keep pace with his companions, perhaps it is because he hears a different drummer.” – Henry David Thoreau

The difference between our realities and imagined perfect selves is the extent of our loss of confidence. The ability to recognize the difference and let go of the perfect self is to regain the self and all that is valuable with it. When we decide to adhere to a purported image that may be at odds with what we truly are, we place ourselves in a position of lost confidence.

Andrew has decided to become an accountant. His uncle is an accountant – an uncle who has travelled around the world and appears to be highly successful. Andrew watches his uncle and admires the way his uncle strides into the room, the manner in which he overtakes the conversation and the way the people around watch mesmerized as he speaks. He has wanted to be like this since his childhood.

Andrew is eighteen years old and is at the crossroads of his life. The decisions he takes from now will determine how he spends a large part of his time for the rest of his working life. Andrew is sensitive and understands people. He is very good at drama and mimicry. His speed at learning languages makes him a good choice for any career that requires communication skills. His work with numbers has always been a challenge. He is error-prone and has never liked mathematics.

Yet, he has decided to be an accountant.

Andrew’s mother dislikes this uncle. She views him as arrogant and overbearing. He has scant respect for the views of others and tends to exaggerate his small victories. She is aware of Andrew’s impressions and chooses to avoid letting him see the uncle differently. She prefers to let Andrew choose his choice of career since he is big enough to decide things for himself now. If the choice is colored by an impression of an uncle, so be it. People choose their careers on the strength of much less. If asked her opinion, she will reveal that she feels that accounting is not the right choice for Andrew.

Andrew starts working at a small accounting firm. His work is shoddy and he is given time to learn the ropes. Two other students who are working with him have proved to be quick learners while he is still struggling. He tends to forget instructions and finds himself at a loss to explain how he arrives at certain numerical results.

Andrew decides to improve himself by working harder than before. He finds himself grasping concepts but is stressed by the end of a few hours of working. He improves with time but realizes that he cannot be at par with his peers. He is dejected. At times, Andrew daydreams about being able to stride confidently into a room and be accepted, just like his uncle. When he is taken up by his superiors about the quality of his work, Andrew is crushed. His colleagues seem supportive but Andrew senses their exasperation. He withdraws into a shell and feels useless. In fact, when he thinks about it, there is nothing he can do right, he is really quite stupid. He worries that he is so useless he will never be able to do anything correctly. He is afraid to search for another job lest he spoils things again.

Before long, Andrew is in an emotionally downward spiral. He is unable to analyze the situation and see that he is but a player in it – a player with a choice. He is afraid of his superiors at work and withdrawn from peers because he is certain they taunt him when he is not around. Sometimes he wishes he could talk to someone but cannot identify a person to approach. His current state of feeling that he is stupid rather than seeing that he is following the wrong path, will not help him to find the right way ahead.

Negative emotions cloud out perspective and bring in a state of self-doubt. A daunting wall of apprehension, disgust, and self-hate is formed and stands in the way of the ability to look at life with a positive mind. It is necessary to overcome this barrier and make way for reflection and action in a bid to regain confidence.

We daydream and see ourselves in positive situations and with superior abilities to manage conflicting situations. The daydreaming is a necessary part of opting for a direction that may lead us to what is good for us. The error lies on choosing to emulate an icon without an understanding the unseen context of the supposed superior personality. Low understanding is at the base of adoration that youngsters feel about larger than life adults.

Can Andrew’s mother help? Of course, the notion that one’s child is ‘old’ or ‘big’ enough supposes that with the coming of age, a person is automatically blessed with the capacity to be the player as well as the overseer. If one has a perspective that will bring a positive direction to a floundering other, it must be shared. The ability to be both player and overseer allows the person to step back for a moment and carry out a rational assessment of the situation. Life will throw us into situations requiring us to look beyond the ken of personal experience. At such times, discussion with another person that helps us to direct our thought is invaluable.

Andrew’s career decision is based on insufficient information both about himself and the uncle he holds in high esteem. He has to work out what he likes on the basis of the type of person he is. There are career options to suit individual preferences or it is time for an individual to create a personal niche. The way ahead for Andrew is to take a breather from the work he is currently doing and look at alternatives after discussion with well-meaning people who can provide gentle support without overweening and controlling his choices.

Many of us view realism to be a scientific and rational choice. Yet, there are times in our lives when we will question whether realism is helping us to experience life and all it offers or limiting our experiences.

A scientist of international repute had a trusted driver. One day the driver let the scientist in on a personal desire “I wish I could be a teacher”. The scientist looked on approvingly and said, “If that is what you want to be, go ahead with it. Do not give your life up to your current situation.” The driver lay great store by the wisdom of his boss and went ahead to complete his studies and is now in the process of setting up a school for children from impoverished backgrounds. The family situation of poverty, numerous siblings, squabbling parents and lack of support had taken him through the seamier sides of life until he found himself at a center for teenagers in trouble. He had gone ahead to learn driving and felt he was lucky to be working with the scientist. However, when he reflected on his past, he realized that he had been singularly fortunate to have come in contact with an academically inclined and supportive person like his boss. Many of the youngsters with whom he had roamed the streets with were dead or sunk in habit traps that made life miserable. They might have had a chance with useful guidance. He wanted to provide the guidance.

This is what people who win against all odds require – the belief that a dream is possible. When we are in a long term situation of difficulty, we start to accept the present as the reality that we have to live with. In such a case, the capacity to dream is impaired and the individual ceases to try to get out of the negativity of the present situation. Few have the power to dream, lesser still have the ability to live the dream. Belief in the dream requires reinforcement and it is wise to receive this from the right quarters.

Dreaming

Dreams are the source of hope for better. Dreams bring us to a superior realm far from wretchedness and despair. Dreams are the idea base when we presume to have reached rock bottom. The value of dreams lies in its ability to show us a path, a solution or a hint at a mental roadblock. Dreams motivate us to find a way out of hell.

Dreams must be shared with care and respect by the dreamer and the listener. If shared with the wrong sort, they can lose their intrinsic ability to light up our lives and are regarded as worthless. If the driver had spoken to a frustrated peer circle in the hope of receiving encouragement and instead been at the receiving end of negative comments about the possibility, no lasting benefit would have accrued.

What would have happened if the driver’s statement about wanting to be a teacher had been thwarted by the scientist? For one, since the driver had a high opinion of the scientist’s opinion, the dream would have been demolished or would have lain forgotten. The driver would have considered the dream to be foolish and continued with the reality of the present. Worse, the driver might have decided that dreams that gave him a vision beyond the present were not worthy of consideration.

Dreamers may prefer to share their thoughts with only a few who they can trust with their secrets.

There is interplay between our hope for our lives and the actions we take. In the situation of the driver, it was not possible to follow the dream without keeping a steady job as a driver. The work hours were erratic but allowed ample time for reading in between rides. The driver had to be realistic and continue working even as he followed a full-fledged study course with little external help. The motivation that made this possible was the dream of what could be achieved.

Realism

There is a place for realism as there is for dreaming. Realism is the force that allows one to envision the future and plan actions in the present. Realism allows an understanding of whether a dream is possible or not. Realism allows us to weigh whether the present situation calls for change while considering our emotional needs.

A young man completed his business degree from a reputed college and decided to try to live the dream of starting a rock group. He scouted the industry and analyzed his scope for entry and growth. He realized that he should have started out on this career much earlier. If he followed the dream, his plans for marriage would have to be postponed and he could not be certain about the return on his investments. The few who started late had tried forays of some sort in the field at a young age and had some acceptance in the industry, yet they were struggling. He decided to keep his rock star dreams aside and returned to corporate life and satisfied his need to have a steady family life. He meets his music group for holidays and weekends to make music so that he does not lose touch with his talent.

Here was a case of a dream being chased and dropped because of a perceived low possibility of success. The man took an approach that allowed him to enjoy family life and the benefits of a job that was in line with his education after weighing the pros and cons of pursuing his dream. There are many who would opt for leaving all other aspects of life in pursuit of their goals. This man considered his personal priorities and choices before giving up the pursuit of musical success.

Yet, there are people who believe that it is better to follow their dreams without allowing realism to come in their way. Some forge ahead to stardom while others lie forgotten.

Planning

A young adult may dream of success and have no clue what to do to reach there while another spends the time preparing a plan that considers options. The options include personal preferences, current realities (financial situation, educational merit) and future vision. Life throws every individual into a variety of events. When we look at these two cases, we might assess the second person as more capable of handling this variety. Life may not follow these formulae. It is possible for the first person to find a suitable path after initially getting tossed about by circumstances while the second lives a life of seeming success but intrinsically low on value.

It is not possible to conclude on the better path rather it is important to choose a path that suits the individual. The suitability of a path becomes apparent only after we have traversed it some part of the way and enjoy the wisdom of hindsight.

Dreams are the source of the belief in something better. Dreams and visions might save us when we feel we have reached the bottom. Dreams and reality are not always compatible, and the challenge is how to find a good balance between reality and dreams in relation to important choices in life.

Each of us comes to this lifetime with intrinsic capabilities. Identifying what we want to do and finding the way to go about it is an onerous task. We may have the skill but lack the will to follow an arduous route, we may be hardworking but unable to find something we like or we may have a background that focuses on pure survival rather than skill development. We may be comfortable in our realities or may be in search of that elusive better choice. Our dreams are but a response to the need we have within.

Life choice

Many are caught up by the visible signs of success that the media continuously flashes on our screens. The public life with its fame and wealth creates a sense of perfection about the perfection of famous people’s lives. A person who runs for presidency or any other public office does so because of the opportunity to be involved in larger good.

An overweight youngster might decide to follow a dream of a career on the catwalk. The glitter of lucre, a happy life of parties and freedom might seem the better choice over a seemingly frumpy academic career. The youngster shows signs of commitment and does everything possible to look right and learn the necessary skills. Once all that has to be done has been done, the youngster tries to make a foray into the fashion world and fails to gain acceptance. Rejected by most agencies, the youngster is soon depressed and desperate. Dreams that have been nurtured over the years are often shattered by the realities of business.

If the dream is laughed off as a frivolous choice, the individual is likely to find a more receptive listener. Youngsters must be made aware of the work and life behind the scenes and how people are chosen. They must be made to scientifically understand the effect of their choices on the body and mind and continuously helped along a route towards good health. An understanding of the limitations of public life should be clear and the person should weigh the gains and losses of the career choice in mind. The most important aspect to stress is the presence of choices when all else fails. Healthy choices must be encouraged. If the person possesses the necessary qualifications to follow a dream – in this case, the physical aspect, facial features and attitude – the choice might be right but if the path starts to look unattractive on closer inspection, the individual must have the inner strength to choose a better path.

So, dreams are followed with awareness that in case there is a souring of experience, life can continue with a new alternative. All that is required is the vision and willingness to choose.

A person who is moving along a chosen path may feel bitter about the choice for a variety of reasons like limited earning potential, insufficient recognition for effort, a perceived gap in skill utilization or just a sense of disappointment with the reality. Internal politics or ideology clashes or a feeling that something more is to be attained can create disillusionment with the career choice. Some people may decide to expend their energies in alternate areas like community work, social work or skill enhancement. This is an approach that accepts the reality of needing or wanting to continue in the situation for the present.

A seemingly perfect choice may lose relevance with time and force the adoption of an alternate dream. Dreams are a guiding light with suggestions of possibilities. The decision to give up an earlier dream and adopt a new one is difficult. Monetary conditions, family pressures, personal inhibitions and a host of other factors can come in the way of the choice. Realism in such a case provides a keen sense of security that the present is better than the uncertainty that change brings with it.

We continuously weigh our dreams and circumstances. Some people may feel that they have nothing. They get caught up in the runaround of everyday living. Family members keep their personal preferences at bay and live to care for others. As long as a person feels fulfilled about this choice, there is no dissonance between self-image and reality. If, however, the individual feels trapped by the situation, it is time to follow a route that allows for fulfillment of personal needs while managing the current reality.

How to dream

When we talk of dreaming, is the reference to what happens in an unconscious sleep state? On the contrary, the reference is to those feelings and thoughts that we have under different conditions. A person may look at a hoodlum in jail and feel a sense of fear while another sees this as an opportunity to add value by changing a life. A person may watch the television screen and be carried away by the personality of the presenter while another considers the information being shared and how it is prepared. Each of us has a personal preference and this forms an important aspect of the dream. One important step to formulate a dream is to recall the feelings you have had over a long period of time. You would have appreciated or disliked a number of events that went by. Of these events, were there any that led you to believe you could have made a difference?

Jane hated the idea of being mugged on the streets and chose to learn a martial art form to help her overcome the fear. Over time, she realized that she liked training others and chose a course to help her in the field. The foray led her to learning alternative forms of fitness. She now runs a gym that caters to new mothers and provides personal training and dietary advice.

The second thing to consider is the kind of person you are and your current situation. Do you like traveling to different cultures and meeting new types of people? Do you describe yourself as hardworking, physically active and involved or are you a laidback type of person who is good at executing? Are you willing and able to invest in a suitable course of study or not? Questions that gauge what you like and weighing it against what you can do will help you to find answers.

If you come to the conclusion that you know nothing about yourself and do not think you are worth much talk to a friend or parent who will give you a clue about your strengths.

There is another aspect of dream formulation. What do you do during your spare time? A music lover may choose to play over the weekends or teach despite holding a full-time demanding job.

An engineer who spent most of his life in study and hard work suddenly decided to start a food chain. He had spent a large amount of time in creating recipes and had long since decided that the field earlier chosen was not suitable. The activity that had taken up spare time became an enjoyable vocation.

If there are a number of parallel dreams under consideration – well, it is time for a dose of reality to effectively set priorities.

The trouble with viewing oneself to be a victim is that it allows the ‘victim’ to carry out any wrongdoings or hurt others and not see the effect or own responsibility for their actions.

When Ronald’s parents decided not to send him for a school tour for which he was chosen, he accepted silently. As he grew older, when they decided that he should give up the love of his life, he silently surrendered. They decided the course he should study, the job to be taken and the money he should earn. Ronald finally married a girl that they found suitable and had children of his own. His wife did not understand his attitude to life. Every time there was a conflict, Ron would back off and give up the fight. He would accept the hopelessness of the situation and his own helplessness and refused to put up a defense. He frequently blamed people other than himself for all that went wrong with his life. He had problems at work that he attributed to other people’s attitudes. He blamed his parents for taking away his right to choose and develop. He loved them but never hesitated to point out their wrongdoings that had spoilt his chances twenty or thirty years ago.

One day, Ron collapsed in the house from a seeming overdose of alcohol. Ron’s wife was aware that he drank occasionally but the event brought forth the possibility that the drinking was more than occasional. On closer questioning, Ronald revealed that the drinking had started during his teens. His wife was devastated. They had tried their best to make sure that Ronald grew up ‘clean’. Ron returned home promising to stop the habit. One day, Ronald lost his job.

Ron’s wife received an urgent missive at work. She had to return home immediately. When she got home, she found Ron in a state of collapse. Her children and the baby sitter had taken shelter in the neighbor’s home. Ronald had gone berserk. He had shouted at the children, smashed a window and collapsed in a heap. The babysitter informed Ron’s wife that she would not come over to help out again. The children were scared to return home. Stressed and worried, Ronald’s wife confronted him with an ultimatum.

Ronald went berserk and started breaking furniture while he screamed and blamed his wife for all his troubles. He had lost his job because of her. He had not wanted children and found himself saddled with two of them. All his unhappiness stemmed from his wife’s adamant behavior.

By the end of the tirade, the children were wailing and his wife was packing the bags to leave. Ronald dozed off to sleep even as his family left the house. The next morning, a repentant Ron slashed his wrists and landed in hospital in a critical condition.

Where does the cycle of victimization start? Who is being treated unfairly? Often, the victim enters a cycle of being a victim and victimizing others. If Ronald’s wife had allowed the behavior to be treated as normal, he would have continued to treat her as the cause of his woes. The point when victimization starts is difficult to determine but the feelings associated with the experience remain fresh in the memory of the person. A person who has been brutally beaten or threatened at any phase of life will retain the memory of abject fear and helplessness for a long time to come. In Ronald’s case, the acquiescence he displayed as a youngster was viewed as maturity. The possibility that he might have resented the parental injunctions did not strike the family as possible.

So, rage has its base in oppression whether forced with intimidation and violence or brought about with the use of emotional duress. Ronald has not developed the judgment about the effect of actions nor has he taken the step of independent action to develop confidence in his abilities.

The trouble with viewing oneself to be a victim is that it allows the ‘victim’ to carry out any form of wrongdoing, cause willful harm or hurt to others and not see the effect or own responsibility for their actions. Typically, victims see themselves as the sufferers in all kinds of situations. The violent husband blames the wife for being a flirt; the abusive parent blames the child for provocation or the angry boss who blames subordinates for all the problems in the department. Ronald’s parents lacked the vision to see the effects of their excessive suppression of the boy’s preferences. There are many parents who would do much more like depriving the child for disobedience or resorting to violence.

Victims are prone to bouts of raging. Potter-Effron presents an analogy to explain the transformation into rage. ‘Water is pouring into streams and rivers, threatening to flood the land. Only a single dam lies in the way. But can that dam hold back the flood?’ The water represents anger. Normally, people who get into bouts of rage are likely to hold their feelings until their emotional dam can no longer take it. The stream of anger that flows is unbridled and dates back from an unknown time in the past.

A mix of angst from acquiescence, rage and addiction form a potent mix that can cause grievous harm to the individual and the family. Ronald may plead that his family return or he may turn to his parents for support. He may decide that marriage was a mistake and alternate the thought with an opinion about how precious his family is. This dilly-dallying will increase his dissonance and cause him to try to harm someone else again.

Is Ronald likely to be open to the suggestion that he is responsible for his current situation? Will he be able to help himself out of this situation? Should his wife allow the situation to remain as is in the hope that things will change? No, to all.

Ronald will have to enter rehabilitation and take professional help about his attitude and learn to identify when he is responsible. In the meantime, he should take the effort to spend time with the children since the past behaviors have created a sense of fear in their minds.

Ronald’s wife will need to bide her time to gauge whether there is a future for the marriage. She should take a positive stand in permitting him to be involved with the children.

How does this situation sort itself? That depends completely on Ronald’s willingness to see himself as the driving force on the road to recovery.

Juliet struggles with aggression and low self-esteem, which probably relates to her difficult childhood. An overly involved mother and the use of corporal punishment has left Juliet with emotional trauma. How can she manage her anger problems?

Juliet is a 20 year old and has a huge problem with anger. She starts slapping her face, pulling her hair and biting her hands when she is angry. She finds it difficult to concentrate on her work and finds that when she is under stress of some sort, her brain goes to sleep. She has faced this problem from as far back as she can remember. This is her way of getting her brain to order. When she was a school student, she regularly beat herself to make her mind concentrate on her homework, her projects and exams. Thank God for Mummy, she always came to the rescue when Juliet showed signs of distress.

A strict disciplinarian, Juliet’s mother had always felt her daughter was difficult, even as a little girl. Slow to start speaking, Juliet had been a hurricane of a child, always in a rush and always getting her hands in all the wrong places. No amount of harshness had made an impact on the girl. She must have been slow, her mother averred because it wasn’t till she was 5 that she made coherent sentences. At some point, the hurricane aspect of the girl reduced but she remained short-tempered and resentful. Juliet’s mother had never understood why and how her daughter had turned out this way. It seemed like the stricter she was with Juliet, the more trouble she got into.

Juliet’s aunt had a different view point. She felt her sister was too harsh with Juliet from the start. Juliet’s mother had beaten her when she was less than a year old. The reason – the baby had dropped a glass bottle. When the baby was a toddler, she had climbed on to the bed and started jumping on it. Irate that the freshly made bed was getting spoilt, Juliet’s mother had ordered her off it, but not without smacking her across the face. The mother insisted on carrying her everywhere to avoid her getting her frock dirty until she was five years old. Juliet’s mother viewed arguments as a sign of disrespect. Whenever Juliet showed signs of obstinacy, her mother would give her a ‘hard one’ across her face. When Juliet stopped crying, her mother made it a point to continue to beat her until she broke down. ‘That is how you break obstinacy’. When there was an argument, you could never tell what it was about. Juliet’s mother would be screaming about all the trouble she had taken to bring up her child while Juliet would be screaming about wanting to do something or the other and how her mother always came in the way.

Juliet couldn’t deny that she had got through the difficult years of education because of her mother. Every time Juliet sat to do her work and faced a difficulty, her mother would come over and help her, at times, completing her homework for her. Unfortunately, Juliet never got to do the things she liked either. When there was a drawing competition at school, her mother insisted that Juliet complete her homework and studies and leave the drawing for her mother to do. Upset, Juliet refused to show the drawing to the teacher. Her mother had been hurt by Juliet’s attitude towards her effort but let it go as a part of callousness of youth.

Let us try to understand what has been happening. Juliet was a ‘hurricane’ as a child, always on the move. We must see the connection between her delayed speech and the energy that emanates from the desire to speak that remains trapped within. This leads to an effort to make the listener understand by way of physical gestures. When the communication fails, the child shows signs of agitation.

Is it possible to stay silent when one wants to express a thought or feeling? A person who has to keep quiet when in a state of anger is likely to throw something or tear papers or punch a pillow. The agitation will come out in the form of physical activity that appears disruptive to the onlooker but feels normal to the person who with suppressed emotions. In the case of Juliet, the parent has missed out on understanding the child’s context and focused on propriety. The child felt the reaction and was enraged as well as frightened. If Juliet’s mother harks back in time, she will realize that Juliet’s behavior came under some control when she was able to verbalize her needs.

Unfortunately, Juliet’s mother had started using physical means to control her child which impeded communication. She has also tried to create dependence on herself, possibly in the hope of emotional redemption. So, Juliet believes that she cannot do anything correctly and hates herself more and more.

Recovery

The fact that Juliet is trying to overcome her fears by engaging in work is a sign that she is motivated to feel better. This means that if the suitable path is charted, she may falter and prefer to withdraw at times, but there is hope for her to recover the feelings of being able.

The first thing to do is to highlight all that Juliet DOES correctly. In the course of the day, Juliet must be doing some things right at work and at home. If she loses her job as she fears, it is possible that she needs to identify work that she really wants to be involved in or needs to add to her skill set. Either way, the loss of a job is not a sign of lack of ability; it is a sign of lack of fit between the individual and the role.

Juliet will take time to come to terms with the fact that her mother was flawed in certain parenting practices and the problem was not Julia’s. She will have to accept that she is personally capable of completing work that is assigned to her without intervention and takeover of the job. She needs to recognize that her belief in her inability to independently do a job is associated with insufficient habit formation at a young age. Concentration on a task can be improved with the introduction of suitable habits in the absence of other issues linked to this aspect of mental work.

She must engage herself in soothing activities that induce creativity to flow and recognize her ability. The choice of activity must be connected with intrinsic talents that she possesses to avoid reinforcement of her lack of self-belief. She must choose and be encouraged to stay with the choice for a given time period.

Professional help is needed to help her overcome her habit of hurting herself when she finds it difficult to concentrate.

Once she is able to direct her mind to areas of more fruitful activity, she will be able to learn to harness the energy that anger creates in a way that is appropriate rather than harmful to her. This will improve her acceptability in professional and personal relationships.

Good communication can be difficult to maintain in stressful daily life. The ability to talk to each other is an essential ingredient in what is called quality time. How is this in a relationship? ‘Quality of life’, ‘quality time’ and other terms related to ‘quality’ are in regular use. Pause and think about what this means.

‘Quality of life’, ‘quality time’ and other terms related to ‘quality’ are in regular use. Pause and think about what this means. Quality is intrinsic to an experience but there seems to be a wide range of interpretations about what quality means. Consider the case of a woman who made it a point to spend an hour of ‘quality time’ with her teenage daughter every day. These sessions normally ended in flaming rows with her daughter and had her questioning what ‘quality time’ was about anyway?

Let us think about the term ‘quality’. When an airline company talks about quality, the customer expects an experience of safety, comfort and any other benefits to be accrued. A retailer may want to put forth a high ‘quality’ experience to the customer based on value, feel and speed. A service provider looks to create a service that makes the user feel good about the purchase. Organizations the world over recognize the quality of their internal processes and products determine their success in the market. Merrill highlights the belief that ‘Customer opinion of our products and services is the most valuable driving force for our business.’

When we speak of quality, we think in terms of well-defined processes that help guarantee an outcome. A high quality diet ensures good health and appearance while high quality exercise increases the feeling of fitness. Quality in the medical industry assures the customer of the safety of medicines and health services. The same applies to quality in our personal lives. The difference lies in the fact that the end-customer is the self and family or partners. The processes refer to those of thought, discussion and behavior patterns that a family adopts.

Let us return to the case of the quality time between mother and teenage daughter. The mother had intended that there would be serious discussion since communication between them was lacking. The daughter on her part was unsure of why this exercise was being done at all. The good maternal effort was rewarded with belligerence and resentment. Families with working parents and young children will commonly face the issue of low communication. Work pressures on the adults and the young take away a large part of the time. Home administration, health maintenance and the effort to direct children appropriately can overwhelm the most resilient among us. Communication becomes transactional and difficult to sustain under the various pressures.

A quality process in a relationship is one that leaves both members feeling good in each other’s company. A few moments in shared laughter, joint activity or just light conversation can help people bond much better than a formalized approach. If the quality time is intended for individual benefit, gauge its effectiveness on how you feel. You may decide to enter an exercise program to ‘look after yourself’ and come away feeling too tired. If this is a recurring experience, it is time to review the diet and exercise patterns.

Quality involves introducing new and better processes into a lifestyle and verifying user acceptance (in this case the body) before inculcating them as a part of your life. An increased quality should provide benefits like better sense of well-being, positive mental frame and improved health.

Planning quality time

Possibly the conversation between the mother and daughter veers to criticism and judgments making the daughter prefer to avoid the communication. The pattern of communication has been set and requires a complete change. For one thing, the mother should consider what her daughter likes doing. Maybe window shopping or a trip to the movies or a long drive for the perfect ice cream can create a congenial environment for the rift in the relationship to be set right. The mother must decide to avoid touchy issues that will bring back the same reactions. A relaxing outing that allows the mother to see the innate abilities of the daughter and vice versa can be an eye opener. In order for the relationship to thaw, the two parties must be in a state of relaxation.

What are the conversations the mother can initiate? The mother may be wary about the friend’s circle that her daughter has become a part of or of behavior patterns on display that suggest a bigger problem elsewhere. An accusatory approach will yield no benefit while one that makes the teenager give in on the strength of emotional blackmail will lead to a suppression of facts.

The mother may start by relating errors of judgment that she made as a youngster. This helps the daughter to realize that the mother is not approaching the conversation from a higher ground. The daughter may feel defensive initially but when she sees that she is not directly under attack, it is an invitation to stay. The mother may relate things she saw and experienced and how her friends and their parents managed their situations. If the daughter has similar stories to relate, she may open up a little. Depending on the mindset, the girl may choose to listen to the narratives and relate them with her experiences without sharing her doubts openly.

The time shared can be measured for its quality on the strength of improvements in communication, openness, ability to openly discuss ‘touchy’ issues and share perspectives. The individuals involved must start to feel a stronger emotional bond and trust as a result of the efforts to improve the quality of the time spent together.

Bibliography

Memories can suddenly strike and inflict anxiety and panic in an otherwise harmless situation. Mental noise disrupts the lives of many people. Memories have the capacity to alter our feelings, change our world view and perception of the realities that surround us.

Memories have the capacity to alter our feelings, change our world view and perception of the realities that surround us. Yet, we spare little time to consider the nature of memory itself. Chance events, random words and smells have the capacity to trigger memories and bring in a flurry of thoughts associated along with them. Isaac Asimov recounts a chance tune wafting from a music shop that suddenly transported him to a time in his teenage and brought a host of happy memories along with it. Events that have led to emotional trauma come in with a similar rush and force a seemingly normal person to relive a past experience. What is it that causes this rush of memory and emotions of elation or depression?

The working of memory

Joe Dispenza explains the working of neural connections in creating lasting memories. He explains that the brain processes incoming information from the five sense organs. When an event causes a reaction that leads to concurrent physiological changes like rapid breath, tightening of abdominal muscles, mouth dryness or clammy palms, the brain registers the reaction. This is a form of learning.

The mind falls into a set pattern of thought. From the moment of awakening, the brain instructs us to carry out a set pattern of activities and somewhere deep within we can hear a continuous barrage of seemingly inane conversation. The inane conversation may be repetitive and leave us unaffected. In some cases the chatter is so severe, that the listener is unable to continue normal work because of it. New events or non-routine activity that set the brain into a new pattern of planning make it possible to overcome the chatter.

What is this continuous chatter that goes on in our heads? Does it go when the pattern of activity changes? For instance, if the normal habit is to wake up and put the water to boil for a cup of tea and is changed by a new action of opening a window and gazing at the sky for a few minutes instead, does the chattering stop? Is there a physiological connection with the constant barrage of verbosity that continues in the head? Can the introduction of a new activity to break the routine change the trend of thought?

Old conflicts that have been left unresolved, anger that continues to fill the mind, negative comments that we have given credence often form the base of the chatter. “This is going to go wrong”, “Never do anything right”, “Always makes mistakes” and similar thoughts that lead to an unpleasant churn at the physiological level and fulfil the words as they repeat in our minds. The distress of fulfilling the negative comments that fill the brain further strengthen the words and reactions and install an irrational sense of fear from moving ahead. The negative outcome becomes proof of the very quality that we try to overcome.

Sometimes, the mental conversation comes in the way of regular activity, the person moves to the refrigerator to take out a bottle of water but forgets what the frig was opened for. A quick retracing of steps quickly brings back the memory of the need but what is happening here? The mental conversation has overtaken the conscious brain and has brought a state of ‘absent-mindedness’ or ‘forgetfulness’. This is a thought habit that must and can be changed with a set of habits that bring the conscious brain’s commands to the fore.

Adopting a new view

As our brain follows the habit of so many years, we must understand it as an organ that is merely reproducing what it has been fed. If you have spent years hearing and unwittingly agreeing to other people who provide negative inputs about you, your brain has been fed potentially disastrous thoughts. As life takes you along its path, you start to feel that you are responsible for things that go wrong. Consider this, you have always been told that you are difficult and stubborn. When you enter the stage of young adulthood, you go through a series of failed relationships. This serves to prove the statements that have been said. You decide to adopt a new strategy, one of hiding your personal views when you enter the next relationship. This is not a lasting solution.

Instead, accept that the relationships were life’s ways of teaching you about yourself. If you look at a relationship as a sort of instruction manual you will start to see behavior trends that appear. Maybe you are impulsive, easily manipulated or maybe you keep your feelings under such tight control that your partner feels you are not serious about the relationship. If you look at this with a clear mind, you will find that your responses to situations are being driven by the thoughts that you carry.

Feed your brain appropriately

If you look at thoughts as brain food, it is time to change the brain food that you have been having. Make a conscious decision to watch your thoughts. When you are given a new assignment, do you say, “Oh no!” Acknowledge the thought and tell yourself “I can do this, I just have to plan it well.” It is similar to getting yourself out of eating something that is bad for your health. You change your eating pattern. But how do you do it? Some people remove the food from their homes completely to control the consumption.

The brain works in an insidious manner and quietly leads you along well trodden paths. Be conscious of what you are thinking at different times of the day and jot it down. Murphy has strongly recommended this habit as a way to track self talk. Let the words flow as you write the context and associated feelings and the words in your head. Now consciously change the negative tone and tell yourself this is just a situation to be managed. You may need help of a friend or a good listener to help you get your feelings at ease when you do this since conflicting thoughts lead to conflicting emotions. The brain will try to continue with the food pattern it is familiar with and will take time to adapt to the new food. It will try to attract you to new habits that lead you along the same thought route.

Do not allow your brain to direct you, learn the art of being conscious and lead the way.

Loneliness – that universal human feeling – can do things to the most rational among us. Loneliness that comes along with a feeling of despair can be a very difficult phase that affects us mentally and physically.

Joel and Mary have been married for 22 years. It was a case of true love. They have two children, both of who have now left home and stay in different cities. The home has changed from filled with sounds and laughter, to what Mary describes as ‘lonely and dark’.

Joel was back at work as usual. Mary has been feeling down and out. The pain in her joints seems to be a permanent feature and getting out of bed is grueling. It has been a month since her son, the younger one, left but Mary has not been able to overcome the deep feeling of sadness. His room bears his presence though it is completely bare. She had not felt this way when her daughter had left and wishes she could feel the sunshine again.

When the kids were pre-teens, Mary stopped working in her full time assignment as an accountant since she felt this was a stage for providing guidance. She looks back at those days fondly. The kids were happy for her presence when they returned from school and she was happy to take small assignments to keep the money flowing in. As the children grew older and more independent, Mary took up larger assignments. She had been busy and she loved it.

The recession came up and she found her earnings dwindling as the companies she worked for first chopped the work-from-home assignments. Around the same time, the kids got admission to university and were gone before she had got used to the idea of their absence.

Joel on his part knows what Mary is going through but he is working longer hours than usual trying to keep his job down. Now that Mary and he are growing older, their medical expenses have started increasing.

Mary knows that Joel still cares about her, it is obvious in the little things he does for her. But, she feels he does not want to talk to her, maybe she is not interesting now. When he returns home in the evenings, he watches television for a while as he drinks a cup of coffee. She tries to make conversation and he listens, but her conversation topics are always inane. He sits late into the night on his personal laptop while she lies awake with her memories.

Mary has started feeling that she doesn’t know anything. At a recent party, Mary found herself standing with a group of old friends and feeling that they were all ignoring her. Joel’s presence doesn’t help because of his work. The children call up once a week; they seem well adjusted and don’t seem to miss her as much as she misses them. Physical pain, loss of work, the work pressure her husband faces and the move of the children seem to have come together and have caused a feeling of disorientation.

Loneliness – that universal human feeling – can do things to the most rational among us. Loneliness that comes along with a feeling of despair can be a very difficult phase that affects us mentally and physically.

Murphy relates a mental predisposition to the perception of loneliness. He describes a thought frame that considers the self as inferior, uninteresting and similar self-descriptions as the preceptor to extreme feelings of loneliness. The person creates a base of self deficit and assumes that others view this deficit in the same manner. The feeling intensifies to a point when the person is unable to view others with an open mental frame. Others are better, they are happier, they have friends because they are interesting are a set of assumptions that people suffering from loneliness make about others in their surroundings.

Sometimes this thought frame leads to alienation of the self from situations that could otherwise lead to bonding. Loneliness occurs as a constant feeling throughout life. Children fight and come away from play until friends return. Celebrities are known to be very lonely despite the adulation that surrounds them.

Butler and Hope have elucidated the effect of stress on the body. Symptoms like stomach upset, heart disease, asthma and arthritis are aggravated under moments of stress. Therapeutic treatment alleviates the pain but it returns as the stress resurfaces.

Loneliness is set off by latent thought processes and in turn aggravates underlying physical conditions that worsen the feelings of the moment. The cycle needs to be broken using a number of measures.

How should Mary manage her feelings? Firstly, she must treat the pain using the methods she normally does. An alternative is to get busy within capacity. The untidy house will worsen the feelings that Mary is undergoing. She will find herself feeling much better once the house has been tidied. A very important activity is to set up a daily routine that involves some time to contact at least one friend or person outside her family. This is better done when she has returned to some level of activity so that she is better able to consider substitute to utilize the time that has crept in with the reduced workload.

Chronic pain is recognized to be a stressor (Caudill, 2008) and stress management techniques are recognized as a way to control stress and reduce pain. Mary will probably benefit from meditating on a word or phrase for as long as she can. Since she is currently having negative thoughts that are likely to crowd her mind, she should use a chant that she can hear. This will increase her sense of well-being.

Getting professional help in identifying her trend of thought, self hurting presumptions about how she is perceived by others and effective ways to capture and alter her trend of thought.

Loneliness may not leave but with effective mental techniques, Mary will know how to guide her mind when thoughts assail her. She will learn to accept that loneliness is not a situation to overcome but a state of mind to manage.

When we go to a family that has just faced a tragic loss, we are trying to express solidarity with the survivors. It can often be difficult to meet people in grief. How should you behave and what to say? How can we offer our condolences in a good way? Here are some guidelines.

The old lady sat slumped on the floor. The body of her 30 year old son lay next to her. Accidental death the record stated. A stream of shocked visitors had started flocking to the door of her house. The visitors spoke among themselves in shocked whispers. Somewhere a child started to cry.

The old lady moved towards her son and stroked his face. She laid her head on his chest. Tears streamed from the eyes of the visitors. Suddenly one person spoke up, “They did a post mortem, tell her not to touch him below his head.” The shocked bystanders glared him into shutting up. The lady heard him as the weight of the words slowly dawned on her.

The funeral was completed and people started returning to their homes. A man came to the side of the old lady and wept openly. “Don’t feel bad,” he said, “you were cursed with the bad luck of outliving your son. What can you do?”

She stared at him blankly. A year after the death of her son, the old lady remembers these two people who spoke to her. She remembers and weeps because the statements compounded the pain of her loss. In an effort to express feelings or thoughts, it is possible to unwittingly cause more pain.

When we go to a family that has just faced a tragic loss, we are trying to express solidarity with the survivors. The surviving family may cry openly, say things incoherently and behave in a manner that seems abnormal. Often we are moved to saying something since we feel the grief too. At times like this, we may say words that will unwittingly cause pain.

Communities across the world have laid down rules for helping the grieving family overcome the loss and move on with life. The overriding purpose for these social rules is to ‘Be There’. Feel the grief, participate in ceremonies, lend a helping hand, listen to the feelings that are expressed are all a part of being there. It is not necessary to speak; in fact it is not advisable to do so.

Death of a loved one creates a deep sense of sadness that no words can provide a salve to. The void of grief can remain for many years, in some cases lifelong.

What to do?

Accept that you are unaware of what to say and remain silent.

If the death has occurred due to an accident or sickness that necessitates limited physical contact with the body, hold the grieving person to pre-empt excess contact. Be available to provide support to elder people from the immediate family.

Sudden death can lead to shock among the family members. Keep a family physician informed so that emergency aid can be provided.

Avoid any reference to the dead person as a body or make a reference to the suffering that the person has undergone. The family may talk openly about it, listen to them.

If you have undergone a similar experience, you may find yourself inundated with past memories of your own; let the tears flow. It is acceptable to stay in a corner and grieve. Control the need to express your feelings in this situation.

If the person who has passed away was ailing and elderly, the acceptance of death may or may not be easy. The elderly spouse or partner may be alive, be sensitive to the fact that a close bond has now snapped. Realize that though the family seems to accept the loss in a rational manner, there is unspoken pain. The appropriate attitude to adopt is that of a listener or of a helper.

When the rituals are completed

The return to outward normalcy may happen within a few days after the passing of a loved one. This does not mean that the person feels fine internally. It is appropriate to initiate contact and let the person or family know that you are available for them when loneliness or grief gets the better of them. If the survivor is an elderly person who is alone, a personal visit makes a difference and makes it possible to talk about the loss.

Friends should take turns to help a common friend especially through the first year after the passing away. This varies depending on the attitude of the survivor towards death. Some people accept death as a transition and are quickly able to return to a state of normalcy by setting new routines that keep them occupied and in good company. Others tend to brood about the loss and require support of a few friends who understand and accept the feelings. Sometimes, the person slumps into a state of being unable to accept the loss and return to the business of living. In such a case, professional advice is required and help must be provided in setting up new daily routines.

Virtual pets, electronic communication and urban landscapes…living in a technological world rather than a natural one can have negative impacts on our mental and physical health, the health of a community, culture and ultimately, the planet.

“We are a technological species, but we also need a deep connection with nature in our lives,” says Peter Kahn, a developmental psychologist. (Science Daily, April 2009)

The biophilia hypothesis is nothing new. Biophilia (love of life) refers to the inherent need that humans have to connect with living things and living processes.

“The human need for nature is linked to the influence of the natural world on our emotional, aesthetic, cognitive and spiritual development; it is not restricted to our material exploitation of nature,” asserts Ross Chapman, who had hoped that this need could be exploited to better nature conservancy. (Chapman, 2002)

Frances (Ming) Kuo, director of the Urbana-Champaign’s Landscape and Human Health Laboratory at the University of Illinois, has been involved in a number of revealing studies about the present disconnect from the natural world.

Because we have evolved to thrive in natural surroundings, Kuo theorizes, nature is inherently interesting and revitalizing to us.

Urban environments, on the other hand, drain our mental resources with constant and urgent stimuli. Paying attention to nature seems to reboot, restore and refresh our ability to pay attention and deal with stress, says Kuo.

Ecotherapy, the restoration of health through contact with nature, is the subject of other research published in the British Medical Journal. Scientists found that small animals such as squirrels and owls can be used therapeutically with children suffering from emotional or behavioral problems.

Researchers also document that being involved in conservation projects helps physical and mental health. Subjects make social connections as well as feeling part of a higher purpose and interrelated system.

Kuo and her colleagues have found that humans in highly urban housing break down just as other animals deprived of their natural habitat. Their social, psychological and physical patterns degrade.

“What you see is increases in aggression, you see disrupted parenting patterns, their social hierarchies are disrupted.” (Science Daily, February, 2009)

Kuo and her colleagues have studied how “green space” or the “green effect” influences those in housing developments devoid of nature. They found that barren landscapes resulted in “decreased civility, less supervision of children, more illegal activity, aggression, property crime, loitering, graffiti and litter” than identical housing units with some degree of grass and trees.

“Roughly 7 percent of the variation in crime that can’t be accounted for by other factors can be accounted for by the number of trees,” Kuo says. “We might call some of that ‘soiling the nest,’ which is not healthy. No organisms do that when they’re in good shape.” (Science Daily, February, 2009)

Kuo says that reduced access to nature seems to produce poor attention, cognitive ability and impulse control while any access to green space results in fewer conflicts, less procrastination on major life goals such as jobs and new homes and creates a more resilient and resourceful outlook on life.

Families are stronger, people live longer and college kids perform better on cognitive tests when nature is accessible.

In two studies of children with ADHD, Kuo found that afflicted children were able to concentrate better and experienced less negative symptoms after outdoor activities in natural settings. The “green effect” was comparable to the effects of ADHD medication.

A Japanese study found that adults lived longer if their homes were within walking distance of a park or other green space and that the green effect was independent of their social or economic status.

A study in the United Kingdom found that health differences between the wealthy and the poor disappeared when green areas were factored in.

In Indianapolis, research finds that children are less overweight or obese in greener neighborhoods.

Kuo points out that those living in inner-city developments “have fatiguing lives, and not particularly rejuvenating home circumstances. They’re just more likely to be at the end of their rope on any given day.”(Thompson, 2009)

The restorative effect of nature “allows us to be our best selves, so we are able to inhibit impulses that we want to be able to inhibit; we can take the long view of things; we can think better.” (Thompson, 2009)

More than half the population of the world now lives in urban environments rather than rural neighborhoods and the potential impact is exponential.

“When you take the individual effects,” says Kuo, “and then you magnify it by the fact that people around you share that same environment, you can actually imagine that they’re really, really significant effects.”(Thompson, 2009)

Bigger Implications

“Videophilia” is a preference for TV, video games and Internet use. A study funded by the Nature Conservancy found that videophilia correlates with a decline in national park visits. The US and Japan are the most “videophilic” societies today but other nations are not far behind.

A study done by University of Washington psychologists found that people could recover from stress significantly more by looking at an actual view of nature rather than seeing the same view on a real-time, high-definition plasma screen.

Oliver Pergams and Patricia Zaradiac, authors of the Nature-Conservancy-funded study, say that “the time children spend in nature determines their environmental awareness as adults.” (Nature.org, 2009)

Even with awareness of global warming and climate change, the authors warn that the lack of true nature encounters could mean that people could come to care less and less about the environment, that “if people stop caring about nature, that would be the greatest environmental threat of all.” (Nature.org, 2009)

Peter Kahn, leader of the University of Washington research, fears what he calls “generational amnesia.”

“The larger concern is that technological nature [viewing the outdoors through TV and playing with robo-pets instead of real ones] will shift the baseline of what people perceive as the full human experience of nature, and that it will contribute to what we call environmental generational amnesia.” (Science Daily, April 2009)

Kahn fears that people measure environmental degradation against a norm that is created during their childhood. Each generation has lesser view and understanding of the natural world than their forefathers.

Even environmentalist sympathizers don’t have a clear sense of the amount of degradation that has occurred, Kahn says. “They see the degradation, but they don’t recognize their own experience is diminished. How many people today feel a loss such as the damming of the Columbia River compared to a wild Columbia river? A lot of us have no concept of a wild river and don’t feel a loss.”(Science Daily , April 2009)

Kahn also says “Poor air quality is a good example of physical degradation. We can choke on the air, and some people suffer asthma, but we tend to think that’s a pretty normal part of the human condition.” (Science Daily, April, 2009)

Kahn worries that soon technological nature will be “good enough,” and that “across generations what will happen is that the good enough will become the good. If we don’t change course, it will impoverish us as a species.”(Science Daily, April, 2009)

Sources

Chapman, Ross (2002): “Exploiting the Human Need for Nature for Successful Protected Area Management”. The George Wright Forum

The real problem with placebos is the ethical considerations of their use. Is it ethical for a doctor to misinform or mislead a patient? The placebo effect is a well-known phenomenon, but also a controversial phenomenon. Can our mental abilities affect the chemistry in our body? Does the way we think, our habit of mind, have a real impact on our physical health? The answer is “YES”.

A survey of US physicians in 2008 shocked many people: over half of American doctors admit to using placebos in their treatment of patients. This and international studies tracking the common use of placebos in medicine is causing quite a stir. Why?

It’s certainly not due to lack of studies concerning the efficacy of placebos. They have a long-established history of use and effectiveness in medical history.

Patients have rid themselves of warts when doctors painted them purple and shrunk cancerous tumors with saline solutions.

Dr. Henry Beecher used sugar pills to relieve the pain of wounded soldier in WWII.

Leonard Cobb found that sham surgery cured angina pain just as well as the real procedure did in the 1970’s.

Patients who underwent surgery for pacemaker implants improved before the devices were even activated.

People undergoing dental surgery got just as much pain relief from a saline solution as those who received actual morphine.

Parkinson’s patients who received fake surgery instead of real implantation of human embryonic dopamine neurons experienced the same benefits as those who had the real surgery.

Skin incisions instead of arthroscopic surgery healed patients with knee osteoarthritis as well as the real deal.

Present-day technology is allowing researchers to begin to pinpoint the physiological bases of placebos: how expectation, thought, conditioning and other mental processes can affect changes in brain opiates, brain impulses and other bodily processes.

A neurologist at the University of Michigan discovered, with the use of fMRI scans, that a placebo pain injection initiated activity in an area of the brain called the nucleus accumbens (NAcc). This is the same area of the brain that controls our expectancy of reward.

Also at the University of Michigan, researchers used molecular imaging to measure the opiate activity in the brain. While inducing muscle pain, they gave volunteers a saline solution as a fake pain reliever.

The saline produced activity in those brain regions that inhibit pain and stress with the brain’s natural opiates, endorphins.

Neuroscientist Donald Price used fMRI technology to scan the brains of patients with irritable bowel syndrome. As they endured a painful procedure, the patients were given what they thought was a pain reliever. Not only did the placebo reduce pain, brain activity declined in five of the pain-sensing regions of the brain.

Research has even found what factors influence the effectiveness of placeboes. Fake surgery works better than injections; injections work better than fake pills; capsules are more effective than tablets; the bigger the pill the better; the more the better; the more expensive…etc.

The real problem with placebos is the ethical considerations of their use. Is it ethical for a doctor to misinform or mislead a patient?

Some doctors admit to prescribing treatments that have no proven efficacy but that is true of many commonly prescribed and popular drugs. Lipitor has only undergone 4 years of study; placebos work as well as many major antidepressant medications 35%- 52% of the time.

Other doctors believe that anything that helps a patient utilize their own power, whatever it may be, to aid in the healing process, just makes sense. This kind of thinking has led to a shift in the perception of placebo-use, how the focus of research could become how to initiate and develop the powers of the mind in healing instead of the focus on proving the basis of their physiological workings.

Researchers Franklin G. Miller, Ted J. Kaptchuk, Daniel E. Moerman and Wayne B. Jonas have proposed a re-conceptualization of the placebo effect. Miller and Kaptchuk believe the whole system should be referred to as “contextual healing.” Moerman and Jonas think of the placebo phenomenon as “the meaning response.”

What all of these researchers point out is the important fact that there is no way to isolate and study the placebo effect: it does not occur in a vacuum; it does not occur out of context. Placebos themselves are “inert;” they don’t cure anything. The many processes that do affect healing occur through the mind.

A doctor’s white coat or a stethoscope can trigger unconscious conditioning or beliefs about the efficacy of treatment. Media coverage can convince patients that a medication is good or bad. The more time a doctor spends with a patient; the more effective any treatment the physician prescribes will be. Telling a patient that a treatment “will work” results in more benefit than saying it “might help.”

Some researchers believe that acupuncture works so well with irritable bowel syndrome and lower back pain because of the increased attention, empathy, focus and time that an acupuncturist client receives versus what they get in a conventional doctor’s appointment. One of the things that is convincing about this theory is the fact that sham acupuncture works just as well as the real deal in many cases.

As one doctor explains, “Our health care system isn’t really set up to reimburse for empathy; it reimburses for widgets. So doling out something becomes sort of a modest gesture toward a mutual hope that the patient will get better.”(Berthold, Jessica 2009)

Neurologist Robert Burton says, “Even given our advanced state of treatments, medical knowledge, much of routine medical care—from treating backaches to the common cold—relies primarily upon reassurance and hope, not disease-specific treatments…we need to reconsider how to facilitate the placebo effect with minimal risk and cost, and without deception. “(Berthold, Jessica 2009)

Miller and Kaptchuk’s contextual healing is based on the premise that health occurs “spontaneously” when conditions are right. They refer to contextual healing as “that aspect that is produced, activated or enhanced by the context of the clinical encounter, as distinct from the specific efficacy of treatment interventions…”

They go on to explain some of the aspects that make up such a context. “Factors that may play a role in contextual healing include the environment of the clinical setting, cognitive and affective communications of clinicians, and the ritual of administering treatment. Attention to contextual healing signifies that there is more to medicine than diagnosing disease and administering proven effective treatments. This has long been recognized under the rubric of ‘the art of medicine.’”(Miller & Kaptchuk 2008)

Moerman and Jonas claim that “For human beings, meaning is everything that placebos are not, richly alive and powerful. However, we know little of this power, although all clinicians have experienced it.” These researchers emphasize that there is no way to avoid the placebo effect, even if one tries to avoid actually prescribing fake pills or treatments. “One cannot… avoid meaning while engaging human beings.”

The researchers note that “eliciting the meaning response requires remarkably little effort (“You will be fine, Mr. Smith.”) So why doesn’t this happen all the time? And why can’t you do it yourself?”

Perhaps, they propose, only when some ritual is added (as in placebo treatments) or when some level of social support adds impetus to the patient’s inner abilities, do benefits occur.

Or, maybe, they muse, “as we have clarified, routinized,and rationalized our medicine, thereby relying on the salicylatesand forgetting about the more meaningful birches, willows, andwintergreen from which they came—in essence, strippingaway Plato’s “charms”—we have impoverished the meaningof our medicine to a degree that it simply doesn’t work as wellas it might any more.” (Moerman & Jonas 2002)

Some scientists are suggesting the development of “meta-placebos” or “curabo treatments.” That is, helping people to understand that they can get help from the placebo effect, helping them to recognize the power of their own minds and insights, empowering or igniting them consciously might be a way to make use of the placebo effect in an ethical way.

One of the strongest arguments for “contextual healing” comes from a recent study of ADHD medications. When a placebo was used, children’s behavior improved. The surprise was that the change in symptoms seemed to have occurred not only because of the children’s expectation and because of “conditioning” about medicine but due to the expectations and beliefs of parents and teachers who believed that real medication was being administered.

Researcher Daniel A. Waschbusch says, “We speculate that the perception that a child is receiving ADHD medication may bring about a shift in attitude in a teacher or caregiver. They may have a more positive view of the child, which could create a better relationship. They may praise the child more, which may induce better behavior.”(Nauert, Rick 2009)

Matthew Budd came to see that 60% of the patients that visit doctors do so because of stress and emotionally-based physical symptoms. He developed an approach for improving health and well-being through improving interpersonal communications between doctors and patients, communication that addressed language, emotions, actions, behavior and the body.

He explains the role doctors, placebos and the mind play in healing.

“One of the things that most people aren’t aware of is that healing is a perfectly normal and natural phenomenon. When you cut your skin by accident or when a surgeon does it by intention, the surgeon may sew it up, but that isn’t healing the wound. The wound heals as an expression of a natural phenomenon. Healing is natural and normal. I think that occurs not only on a physical level, healing forces also restore balance and harmony. What many of us do is impede our own healing.

Healing is a birthright of the organism. I’m talking about the physical, emotional and relational restoration that is the relationship of intimacy; a contextual healing of harmony and trust in which a person feels at home in the world. Those things are impeded by certain barriers. An infection in a wound, the growth of bacteria, would be a barrier to physical healing. The barrier needs to be treated and removed before the healing will occur.

Once we leave the physical realm, the barriers that we need to remove are barriers of perception that generate negative mood states like anxiety, fear, anger, depression and negative connectional states like isolation, lack of relationship, anger, hostility, arrogance, so that we can experience our connection with other people, with nature, and with the whole of creation.

So our healing possibilities lie in identifying and removing barriers at all these different levels rather than in doing anything. If we turn our attention to penetrating, experiencing, understanding, and seeing the delusional nature of these barriers and moving beyond them, then healing will begin to happen.” (Ingrasci, Raz 2001)

In Healing Tasks, James I. Kepner talks about contextual healing.

“Healing is not the curing of pathology. It is the creation of the healing context, where changes occur that could not occur before. This context is not limited to the therapeutic relationship. It must involve the survivor’s support, interpersonal relationships and human environment.

Healing is not just a change within the individual survivor. It is a challenge and reformation of the whole field. It is a series of incremental developments that, taken as a whole, result in a truly transformational process.”(Kepner, 2003)

Can positive thinking affect pain? Absolutely. Pain is a very subjective experience. Expectations, stress, social support and underlying beliefs can influence the degree of pain one feels.

Can positive thinking affect pain? Absolutely. Pain is a very subjective experience. Expectations, stress, social support and underlying beliefs can influence the degree of pain one feels. It’s long been recognized that optimism can influence the experience of pain. What is new is the increasing number of studies that illustrate the physiological changes positive thinking can create in regards to pain.

As, Dr. Michael Selzer, a professor of neurology at the University of Pennsylvania School of medicine says “There have always been people who have said that we could make ourselves better by positive thinking. After pooh-poohing this for years, here are studies that show our thought may actually interact with the brain in a physical way.”(Carroll, Linda 2006)

New research is illustrating how thought affects the biochemistry of the brain, the firing of impulses in the brain and other physiological contributors to pain such as muscle tension, blood pressure and breathing.

Brain scans show that the experience of pain occurs in emotional as well as sensory areas of the brain, and that we have much more control over these areas than most of us would ever guess at.

Recent studies show that one’s belief and expectation about drugs and medications are, in a large part, responsible for their effectiveness. Drugs and medications work to relieve pain by blocking or reducing brain impulses and signals or by increasing the release of the body’s natural pain-killers. Research also shows that we can use a variety of mind-body techniques to do the very same thing.

Placebo research, in particular, is finding that expectation and optimism are determining factors in pain relief.

The placebo effect (the use of fake treatment) has long been documented in terms of pain relief.

Dr. Henry Beecher used sugar pills in WWII to alleviate the pain of wounded soldiers.

Fake chest surgery worked just as well as the real deal to relieve angina pain in the 1950’s and 60’s.

If patients are not told they are receiving morphine for pain, it takes 12% more of the drug for relief to begin.

Similarly, the painkiller CCK agonist had no effect on pain if volunteers weren’t told that’s what they were getting.

Fake acupuncture treatments reduce lower back pain.

Recent research is tracing the physiological effects of positive thinking and pain.

Wake University researchers first conditioned participants to expect low, moderate or high levels of pain (with differing levels of applied heat) according to specific signals.

When researchers mixed up the signals and the levels of heat, the participants reported pain levels according to the signal that they registered, not the level of heat that was applied.

Using functional Magnetic Resonance Imaging (fMRI), the researchers found that a decreased expectation of pain corresponded with decreased activity in specific sensory and emotional areas of the brain.

Expectation reduced the experience of pain by 28%, the same as a shot of morphine.

Researcher Dr. Robert Coghill says that this is important evidence of the importance of cognitive therapy. “Pain is not solely the result of signals coming from an injured body region,” he said, “Pain needs to be treated with more than just pills. The brain can powerfully shape pain, and we need to exploit its power.” (Jones, Michelle D. 2005)

A Duke University study looked at patients with osteoarthritic knees. They found that higher levels of self-efficacy reduced physical disability due to pain. Self-efficacy is the belief that one has the ability to take measures that will improve outcomes. When patients believed that they could influence their condition by what they did…they did.

Catastrophizing is an exaggerated and fearful way or thinking about pain. Catastrophizing exacerbates headaches in young adults, researchers at John Hopkins University found. Teaching participants cognitive behavioral therapy techniques to reduce their distress over pain reduced the frequency and intensity of their headaches.

A Stony Brook University study found that chronic pain patients who had coping resources such as optimism and high self-esteem experienced less severe pain, less life interference from pain and less depression than patients who were not optimistic or who had low levels of self-esteem.

A recent survey found that about 50% of doctors prescribe some degree of placebo because they believe in the beneficial effects. Mind-body techniques and cognitive behavioral therapy are regularly used at pain clinics, cancer treatment centers and the like to help patients manage pain.

“Things like pain don’t just happen to you;” Colombia University’s Dr. Wager explains, “your brain has to interpret the meaning and value to you. Those circuits are partly under our control. The placebo is a way to [control] it beyond what we can [normally] do voluntarily.”(Singer, Emily 2005)

Pain Management Techniques

How does positive thinking affect pain? Awareness is the key.

We are often unaware of how our expectations, our emotions and our mental chatter affect our lives and experiences. Mind-body therapies increase awareness of these dynamics, making the unconscious conscious. With increasing awareness comes increasing control and choice becomes a deciding factor in our perception of pain.

The following are some common pain management techniques that increase awareness, engender change in thought and control, bust stress and decrease pain.

Acceptance

Resistance greatly influences how we perceive pain. Remember the adage “The only thing we have to fear is fear itself?” Like trying to stem the flow of a river, resisting pain is a losing battle that builds up its force.

When you allow the experience of pain, let go of anticipation, fear and tension, pain can flow through you as a current, not as a raging torrent. Some people refer to this as “going into the pain.”

Why can surgeons operate on infants without anesthesia? Infants haven’t yet learned to fear pain; to them it is simply another sensation.

Biofeedback

Biofeedback is a great tool to help us become more aware of the things we usually don’t have conscious control over: heart rate, blood pressure, temperature, muscle tension and brain waves.

Using the EEG, EMG and EDR, subjects learn how these physical responses influence pain and note how their thoughts and emotions can affect these responses.

Emotional Management

Emotions have very powerful effects on pain and they are caused by our thoughts, thoughts that are often so habitual we are unaware of them. A variety of techniques, from anger and stress management to Emotional Freedom Technique (EFT) and Neuro-linguistic Programming (NLP) can help to make us aware of our inner chatter and the anxiety, fear and depression that heighten pain.

Cognitive Behavioral Therapy (CBT) has proven to be one of the most effective therapies for pain. CBT helps to uncover core beliefs and negative thinking that trigger our emotions and behaviors. It gives us the power to change our thinking.

Imagery

Visualization or creative imagery is another powerful tool for pain, health and life changes.

Cancer patients have used creative imagery to shrink tumors; visualization is now a core part of Olympic training programs; remembering a traumatic event can trigger all of the physiological symptoms that occurred then; picturing a loved one causes endorphins to be released.

Some common uses of imagery with pain are those that involve patients imagining themselves “breathing out the pain” or imagining themselves moving freely and easily without pain.

Laughter therapy

It’s not just Patch Adams and Norman Cousins using humor to fight disease and disorder. More and more, studies support the healing power of laughter. It’s been found to reduce pain, decrease stress and boost the immune system. Laughing releases endorphins, increases oxygen uptake, lowers blood pressure. It’s difficult to not have a positive outlook when you’re laughing

Progressive relaxation

Tightening and releasing muscles in a progressive and systematic way increases body awareness and heightens relaxation.

Meditation

Meditation isn’t just the stereotypical lotus-position-palms-upward-thumb-and-pointer-finger-in-a-reverse-OK-symbol.

Meditation involves a slowing and centering of your consciousness, a way of becoming present in your body and the moment fully.

All forms of meditation clear the mind and ease body tension that can heighten pain. They also allow you to become aware of the unconscious chatter that goes on in your head and enable you to disengage from or change that thinking.

Conceptual meditation

Conceptual meditation is the contemplation of deep concepts such as the meaning of pain or suffering, compassion, love, forgiveness, life and death.

Deep breathing

Breathing deep lowers blood pressure and releases tension. Focusing on your breathing brings you into the present and increases your awareness of the connection between the body and the mind.

Mantra meditation

Do you have a favorite mantra? A word, phrase, quote or sound that is affirming? Concentration on something like this can help you to disengage from mental stress and chatter. The “ohmmmm” sound that’s been the butt of so many jokes has a physiological basis: the sound works to release nitric oxide which enlarges blood vessels. This lowers blood pressure and eases muscle tension. “Yummm” and “Zoommmm” work just as well.

Mindful meditation

Mindful meditation involves widening your awareness instead of narrowing your thoughts. Try and expand your awareness and perception of everything going on around you: traffic noises, crickets, birdsong, chatter…It’s a different way of becoming present that allows you to choose and detach from specific sensory input.

Moving meditations

If you’re one of those people with a “monkey mind,” if you find it difficult to be still, try a moving meditation. Tai chi requires such concentration that it empties your mind. Athletes speak of practicing until “they enter the zone.” Creative expression can work in the same way…sculpting, gardening…activity that busies your mind and body can help you to become wholly absorbed in the moment

Prayer

Prayer involves concentration and meditation that calms the mind and eases the spirit. Use prayer to spread and increase positive thoughts and intentions within yourself and for others.

Self-hypnosis

Self-hypnosis can involve visualization, affirmations or other positive messages you work to embed in yourself. The concentration involved helps to reduce pain and relax the body and mind.

Self-monitoring

Most changes involve self-monitoring. Keeping a chronicle or journal can help you identify negative thoughts and beliefs, recognize physical and emotional triggers for pain, and notice other patterns that contribute to your awareness and control of pain.

Gratitude journals, listing the positives of every day, go a long way as far as helping to change negative thinking to optimism.

Positive psychology seeks to identify those things that contribute to well-being, hope and evolution, not only for the individual but also for society. Happiness is probably not wealth, eternal youth or good weather, but rather the ability to engage deeply in our life and be able to install a larger meaning in our daily businesse. So, what makes us happy?

Think Yourself Thin, The Power of Positive Thinking, The Seven Habits of Highly Effective People…these books stay on the bestseller lists for decades. Why? Because they hold universal truths about the power of thought.

Mind-body medicine, the Law of Attraction, Scientology…these things might all seem recent and New-Agey but the premises of positive thinking are as old as the written word.

David, the prophet, said “As one thinketh in his heart so is he.”

Hindu religion teaches that “all things first manifest in the mind.”

It is written in the Talmud that “We do not see things as they are. We see things as we are.”

Positive thinking really took off in the years after the Great Depression, affecting every aspect and institution of life: business, education, literature and psychology.

Napoleon Hill wrote the book said to have launched a million millionaires, Think and Grow Rich, in 1937 and it remains on the bestseller list today.

William James wrote “The greatest discovery of my generation is that man can alter his life simply by altering the attitude of his mind.”

Pioneers like Emile Cou, founder of self-hypnosis, Abraham Maslow and his self-actualizing theory, and Albert Ellis with his Rational Emotive Behavior therapy injected the field of psychology with a different perspective: rather than asking, “What’s wrong? What is the cause of mental illness?” they asked, “What can be? What creates happiness and well-being?”

Today, the field of positive psychology is flourishing, due to the efforts of its founder and present president of the American Psychological Association, Martin Seligman.

Seligman relates two pivotal experiences, epiphanies that gave impetus to his crusade to change his field.

Seligman’s daughter told him: “Daddy, do you remember before my fifth birthday? From the time I was three to the time I was five, I was a whiner. I whined every day. When I turned five, I decided not to whine anymore. That was the hardest thing I’ve ever done. And if I can stop whining, you can stop being such a grouch.” (Seligman, Martin E.P. 2000).

Seligman realized that raising children was not about correcting what is wrong with them (his daughter had done that herself,) but to identify and nurture their strengths.

The other experience Seligman talks about is realizing that the work of psychologists has been to raise the functioning of people from a dysfunctional state to a functioning one, “from a minus five to a zero.”(Wallis, Claudia 2005)

On his first day as president of the APA, Seligman asked, “What are the enabling conditions that make human beings flourish? How do we get from zero to plus five?” (Wallis, Claudia 2005) He had realized that the field of psychology was “half-baked,” that mental health is not simply the absence of mental illness.

In fact, he believes that The National Institute of Mental Health should be called The National Institute of Mental Illness. The founding of the Institute, along with the establishment of the Veteran’s Administration after WWII, gave rise to the domination of pathology and suffering in the field of psychology. Seligman believes that economics are a major reason for this perspective. The Institute was based on a disease-model and many researchers realized they could get funding if they treated mental health as mental illness. Many practitioners realized they could make a living treated wounded and damaged veterans.

The field focused, Seligman says, on the passivity of people, people as victims of broken homes, broken values, political pathology, negative reinforcements and abnormal brains. The questions were “How do we alleviate suffering? How do we fix what is broken?”

After the First World Congress on Positive Psychology, David Cooperrider, creator of the Appreciative Inquiry process remarks, “In some ways we as human beings live in worlds that our questions create.” (Strutzenberger, 2009)

In Living the Wisdom of Tao: The Complete Tao Te Ching and Affirmations, Wayne Dwyer claims, “If you change the way you look at things, the things you look at change.” (Dwyer, Wayne, 2008)

Just as the Law of Attraction emphasizes, if you focus on deficit you give energy and power to lack; if you think of yourself as a victim of circumstance, you disempower yourself. A recent study of journal articles in the social sciences and psychology found that 98% of them focused on negatives such as anger, fear, depression and co-dependency.

Seligman stresses, “Our message is to remind our field that psychology is not just the study of pathology, weakness and damage; it is also the study of strength and virtue. Treatment is not just fixing what is broken; it is nurturing what is best.” (Seligman, Martin E. P. 2000)

Nurturing what is best gives power back to people. It ignites their potentiality instead of emphasizing their limitations.

Positive psychology seeks to identify those things that contribute to well-being, hope and evolution, not only for the individual but also for society. It shares with the emerging preventive health paradigm, the idea that it would serve us best to found generations of people who fortify their health and well-being rather than treating disorders and dysfunction after damage has been done.

What are some of the field’s findings so far? What makes us happy? Money? Youth? Sunny weather? Job or social status, wealth and even health have little effect on life satisfaction. The three strongest factors in happiness seem to be:

Getting more pleasure out of life, savoring its joys.

Becoming more engaged in what you do, increasing the depth of your involvement in family, work, hobbies etc.

Finding ways to make your life more meaningful, using your strengths to serve something larger than yourself.

Of the three, engagement, especially social connection, seems to be the most powerful and pleasure-seeking the least. In fact, pleasure isn’t really the right word.

Pleasure is thought of as the satisfaction of a need such as hunger, warmth, physical contact, rest. Enjoyment, which is more powerful and longer-lasting, is the feeling we get when we stretch ourselves, grow, evolve. It comes from accomplishing something, building something, connecting with someone. Although we may think having nothing to do or being alone will give us pleasure, the opposite effect most often occurs.

Pay it forward

One of the most wonderful things about the advent of positive psychology and the theories of positive thinking is that happiness and optimism are proving to be contagious.

A long-term study conducted by scientists from the University of California and Harvard found that they could measure the spread of happiness in a social network.

Their study covered over 5000 people for 20 years. What they found is that a person’s happiness affects people both directly and indirectly connected to them, that happiness has a 3-degree spread and exponential effects.

What is intriguing is how wide-spread a social network actually is. Your happiness can increase the happiness of a friend-of-a-friend-of-a-friend by 5.6%, more than a $5000 work bonus!

Researcher James Fowler smiles at strangers he regularly encounters and “catches a goofy mood” before he goes home to his sons. “I’m not just going to make my sons happy—I could potentially make my son’s friends happy. These little things I thought I was doing for myself turn out to be for hundreds of people.” (Dahl, Melissa 2008)

What are some of the best tools to increase well-being? Practicing gratitude, practicing altruism and investing in social connections.

Counting your blessings helps you focus on the positive things in your life rather than its frustrations. This mindset increases the potential for more positive things to occur.

Giving to others, “practicing random acts of kindness,” gives your life a higher meaning and helps you to recognize your power and influence.

The stronger your social network, the more embedded and engaged in your life you are, the happier you will be.Or as Father D’Souza once said:At last, it dawned on me, that these obstacles were my life.Happiness is the way…Happiness is a journey, not a destination.”

So treasure every moment you have and remember that time waits for no one…

This perspective has helped me to see there is no way to happiness.

“For a long time it seemed to me that life was about to begin, real life. But, there was always some obstacle in the way, something to be gotten through first, some unfinished business, time still to be served or a debt to be paid. Then life would begin.

Psychologist Sonja Lyubomirsky has this to say about happiness: “Every day you have to renew your commitment. Hopefully, some of the strategies will become habitual over time and not a huge effort.” (Wallis, Claudia 2005)

Sources

Dahl, Melissa (2008): “Your happiness could be contagious.” Msnbc.com

Diaz, Christina (2006-9) “Where Can We Date The Origin of Positive Thinking?” The Benefits of Positive Thinking

Fowler, James H. & Christakis, Nicholas A. (2008): “Dynamic spread of happiness in a large social network: longitudinal analysis over 20 years in the Framingham Heart Study.” BMJ

Hicks, Esther, Hicks, Jerry, (1979-2009): “Health, and the Law of Attraction, Money, and the Law of Attraction, The Universal Law of Attraction.” Excerpts from Money and the Law of Attraction and The Law of Attraction. Abraham-Hicks Publishing

Are we all at risk to develop Internet addiction or are some more likely to than others? How many people are actually addicted to Internet and is there a treatment? Internet Addiction is considered a new diagnosis. Less social activity and lack of sleep are some of the symptoms. For some people will internet represent a convenient opportunity to escape from themselves, their feelings and life's challenges, responsibility and commitment.

Internet addiction used to be thought of as an affliction of computer nerds, geeks, techies or hackers. Statistics are hard to come by but today, some psychologists estimate that there may be as many as 2 million Internet addicts worldwide,1 while other research suggests that the numbers may be even higher: between 1.4 and 17.9% of adolescents may be addicts. 2

Asian countries have some of the highest rates of Internet addiction, where the problem has been recognized (and reported) since the first clinic to treat Internet addiction opened in China in 2005. 3 Xinhua News Agency reports that about 10% of China’s 253 million Internet users have some form of Internet addiction. 4

In South Korea, it is estimated that 4% of children have Internet Addiction Disorder (IAD) and Chinese estimates vary from 2-15%. In the US, it is estimated that 1 in 8 adults suffer from IAD. 5

Dr. Dimitri Christakis believes that increasing time and exposure could make Internet addiction one of the most chronic childhood diseases. Cultural use of the Internet is practically mandated, he says, access is available everywhere. 6

Israelian doctor Joseph Zohar says he sees many people age 20 and up suffering from Internet addiction at his clinic, feeling that Internet use has expanded from a useful tool for them to taking over their lives. “These people gradually sink in this swamp and get on the Internet instead of doing other things they would like to do, and even worse, things they have to do, that are part of their everyday lives,” says Zohar. 7

Bill Gates himself, founder of Microsoft, reports that he is monitoring his 9-year old daughter’s Internet use, fearing that she has begun to develop an addiction. 8

Causes

What are the causes of Internet addiction? Preoccupation with social media networks has exploded and is made more and more accessible with the use of Blackberry’s and iPhones.

“Most people who find a deep satisfaction and pleasure in using Twitter, for example, probably have a deep psychological need that is not being met in normal, everyday life,” says licensed psychologist Dr. Melvyn Preisz. “The unfortunate reality is that our society is starving for genuine communion and genuine intimacy and communication.” 9

Director of the Center for Internet and Technology Addiction Dr. David Greenfield says that social media sites create a sense of personal power and influence. “This is the first time in the history of humankind that the capacity to broadcast is in the hands of everyone on the planet,” he said. “That is incredibly intoxicating!” 10

Dr. Vicki Wyatt takes the stance that this type of behavior is nothing new, that compulsions such as this have always existed and take form according to the social activities and trends that are present at the time. 11

Researchers have identified 12 characteristics of the Internet that make it so addictive: 12 & 13

Ease of Use: Computers, free, wireless and low cost access, portable game players and cell phones all make the Internet easily accessible.

Content: The amount of information on the Internet is so vast that it offers information and interest to everyone.

Privacy: One can travel anywhere on the web within the privacy of their own home.

Community: Even the most unique individuals can find and identify with others on the net.

Freedom to Explore: The Internet is completely mainstream, accepted and expected and easy to use.

Disinhibition: The anonymity involved in interactions online allow people to forgo social and self-imposed restrictions. It allows disclosure and intimacy in ways that aren’t easy or common in real interactions. The “hyperpersonal” venue refers to how one can choose and control what they share and how others view them online.

Sense of Mastery: Ease of use and control over what one shares gives people a sense of mastery (over much alluring mystery,) and online gaming sites entice players with the desire to master new skills.

Interactivity: The interactivity involved in Internet use makes one never feel alone and triggers ongoing online time.

Retrievability: The visual and auditory online schemata is easily retrieved.

Validation: Finding people with common interests and mastering computer skills gives validates people’s identities and self-worth.

Dissociation: Engaging pursuits cause us to lose tract of time.

Boundarylessness: The Internet is an endless source of information and interaction. One never feels done, there is always more to seek out.

Some believe that the available interaction and pursuit of knowledge on the Internet dispel the idea of Internet addiction.

In a discussion room about IAD, one participant comments “Maybe the computer is just nicely interactive in a world of increasingly isolated people.” 14

Another participant remarks, “A person may spend a lot of time on the Internet, as I do, because I have finally found the ‘bottomless’ source of information. There is no last passage to this reference book, and if I am addicted to anything, it is knowledge…Are we not all addicted to something, which keeps us interested in living?” 15

Indeed, one of the characteristics that many researchers agree distinguish excess Internet use from addiction is as Storm King says, “A passion adds value to one’s life, and an addiction takes away value.” 16

And yet this addiction to knowledge…this may prove to be a natural human trait that the Internet, by its very nature, feeds. We may just be hardwired to keep seeking out information on the Internet, even if it disrupts other functions and needs in life.

In the 1950’s, researchers thought they discovered a pleasure center in rat’s brains. The rats would press a lever to stimulate this area in the hypothalamus until they collapsed. 17

Neuroscientist Jaak Panksepp doesn’t believe that pleasure is what was produced in those rats or in humans today. He says that the rats acted excited certainly, but behaved in a foraging, hunting kind of way. 18

Panksepp deems the emotional state triggered as “seeking,” and calls it the “granddaddy of all the [emotional] systems.” It is seeking, the scientist says, that motivates animals all over the world to venture forth into the world. 19

Temple Grandin says that research proves that animals would rather search for their own food than be fed. 20

Panksepp says that the desire to search is not only in order to fulfill physical needs but that we get thrilled about abstract and intangible rewards in the same way. When we get excited about ideas, making connections and finding meaning, our seeking circuitry is afire. 21

Dopamine, the feel-good neurotransmitter that is said to be involved in many addictions, is involved in “states of eagerness and directed purpose,” Panksepp says. 22

Dopamine is also involved with our sense of the passage of time. This is why we can get so engrossed in an activity that we lose track of time. People with hyperactivity have short attention spans and many researchers believe that Internet searches, overload and scrolling is shortening attention spans so that we keep searching for more input. 23

Psychologist Kent Berridge agrees that the rats behavior in the original experiment was not stimulating pleasure and reward. He’s determined that two systems exist in our brains: wanting and liking. 24

The wanting system acts like Panksepp’s seeking system, believes Berridge, and the liking system uses the opiod system to create feelings of pleasure. 25

“The brain seems to be more stingy with mechanisms for pleasure than for desire,” Berridge says, so that there is much more stimulus to seek than there is in gaining the object of our search. In the end, it is the journey that counts more than the destination. 26

One neuroscientist has found that in studies of investors, much more pleasure is experienced with the possibility of reward than actually gaining one. 27

This makes evolutionary sense, says Berridge. Pleasure is supposed to simply pause seeking, not turn it off. We need constant motivation to seek and explore or we wouldn’t thrive. 28

Rats that have had the dopamine-seeking system turned off will starve to death with food in front of them because they have lost the will to go and get it. 29

Berridge believes that in addiction, the seeking system has become highly sensitized even as the payoff lessens. The searching system is self-feeding and doesn’t have satiety triggers built into it. The more we search, the more we want to search more. 30

The new and unexpected stimulate seeking, says Panksepp. Just in the way dogs become hyper-aroused by giving them small amounts of food, we are kept in an aroused seeking state by kernels of information, email-dings and other small cues we get from the Internet. 31

Temple Grandin points out that wild animals would never engage in such useless behavior. A wild cat doesn’t engage in mindless chasing “because it short-circuits intelligent stalking behavior.” 32

Risk Factors

Are we all at risk to develop Internet addiction or are some more likely to than others?

A study of college student found that those prone to fantasy were more likely to become addicted to Internet use and that depression and dissociation tendencies correlate with the tendency to fantasize. 33

Virtual communities offer anonymity, equality and increased access to status that one may not have in the real world.

The experience of trauma has been linked to the development of a host of addictions. It is thought that the helplessness one might experience during emotional, physical or sexual abuse can lead to a kind of self-affirming gratification. 34

Dr. Nancy Wesson has found that clients she treats for extreme shyness often develop obsessional online relationships and that these may be the only interpersonal relationships that exist in their lives. 35

Philip Flores believes addictions are attachment disorders, that we are driven to connect with others and a lack of social attachments cause addicts to gain comfort and pleasure from substances rather than relationships. 36

A study of Internet addicts found that they tended to be lonely, have deviant values and lack emotional and social skills. 37

Michael Gilbert of the Center for the Digital Future says that hyperactive kids tend to become addicted to the Internet because they crave constant stimulation. He says that kids with depression, anger issues and social problems can network on the Internet without having to function in conventionally social ways. 38

Treatment

David Greenfield’s suggestions for combating the compulsive use of the Internet includes42 & 43:

Acknowledging the compulsion

Making the decision to cut back

Telling people of your plan to increase accountability

Picking substitute activities

Choosing specific and quantitative goals

It also helps to identify any underlying issues that may contribute to Internet addiction such as anxiety or depression.

Cognitive behavioral therapy (CBT) is useful in treating many kinds of addictions. Keeping a log of your Internet use, identifying triggers and planning substitute activities for those triggers are all part of CBT.

Building social skills and coping skills is also useful.

There are some 12-step groups that offer support to those with Internet addiction. Surprisingly, many are online.

Alcohol, tobacco, drugs, gambling, shopping, sex, food, video games, internet and work are the 10 most common forms of addiction. What characterizes these forms of addiction? And how can we understand this phenomenon?

When we think of addiction, most of us think of alcohol and drugs. Indeed, alcohol addiction costs just America $250 billion a year, 2 billion people have problems with alcohol worldwide and 185 million abuse drugs. 1 70% of violent crime is enacted by someone under the influence of alcohol or drugs. 2 90% of muggings and theft are related to drug use. 2

But alcohol and drugs aren’t the only crippling addictions. 1 out of 8 Americans are addicted to something. 2 Addiction statistics are scarce because many destructive habits are not yet officially recognized as addiction. Among them, gambling, eating and internet use are problematic for many. The 10 most common addictions are alcohol, tobacco, drugs, gambling, shopping, sex, food, video games, the internet and the addiction to work.

Alcohol

This legal intoxicant is incredibly destructive for both the individual and society at large. The World Health Organization (WHO) reports that alcohol is linked to more than 60 types of disease and injury: it causes 20-30% of worldwide incidences of esophageal cancer, liver cancer and cirrhosis of the liver, epilepsy, murder and motor vehicle accidents. It causes 1.8 million deaths and contributes to 58.3 million of life years worldwide that are lost to disability. 4

Alcohol use is on the rise and is a common factor in violent crimes, including spousal and child abuse.

Tobacco

Tobacco still holds first-place ranking as the substance that causes the most health damage worldwide. 1.3 billion deaths occur because of tobacco addiction annually. In 2002, WHO reported that smoking caused over 90% of the lung cancer cases in men and 70% of the cases of lung cancer in women, 56-80% of the cases of chronic respiratory diseases and 22% of the cases of cardiovascular disease. 5

Tobacco causes 8.8% of deaths worldwide and 4.1% of life years lost to disability. Tobacco use is rising worldwide and is expected to cause 10 million annual deaths by 2020. 70% of those deaths will occur in developing countries. 5

Drugs

The United Nations estimates that 185 million people worldwide were consuming drugs in the late 1990’s. 6

Both prescription medications and illegal drug use is on the rise throughout the world. Many addictive prescription medications such as OxyContin and Vicodin have become as common as marijuana use among young people. 6

Children, especially, make use of volatile organic solvents such as cleaning products, paint, glues and nail polish remover. 7

Drug trade threatens the lives and social fabric of many communities and cultures.

The most heavily used drugs are cannabis, cocaine, heroin and methamphetamines.

Cannabis 8

Cannabis is still the most widely grown, trafficked and used illegal drug and seizures of the crop occur in almost every country in the world. 2.5% of the world population consumes cannabis every year and its use has grown faster than cocaine or heroin abuse.

Marijuana has been linked to the youth culture in almost a rite of passage.

Cocaine 9

Cocaine and crack use occur in 1-3% of the population in developed countries and producing countries and addiction rates have caused many medical and social problems including the spread of crime and disease, violence and fetal exposure.

Heroin 10

The worldwide production of heroin has tripled since 1985 and it is estimated that there are 9.2 million users. Heroin users face 20 to 30 times higher risk of death than non-drug users and the spread of diseases like HIV and hepatitis follow in its wake.

ATS 11

The WHO reports that there has been pronounced production and increase in use of amphetamine-type stimulants (ATS). Methamphetamine use is so widespread and so much in the media that it has become part of cultures worldwide, giving young people a skewed sense of acceptance and safety about their use. There are now about 20 countries in which the use of ATS is more prevalent than that of heroin and cocaine combined.

Gambling

Gambling addiction is on the rise, partly due to accessibility and partly due to a change in acceptability. Today, gambling is available in every corner store and on the Internet. It’s sanctioned by the government and is a source of income for humanitarian social programs.

The top 7 most common forms of gambling are: 12

National lottery and scratch cards

Football pools

Other lotteries and raffles

Fruit machines in pubs

Bingo

Horse racing

Casino gambling

Food

Eating disorders are also on the rise and include anorexia nervosa, bulimia nervosa and compulsive eating.

Many of the eating disorders that exist today may be due to the abundance of food available and its mostly unhealthy nature. Media advertisements, the fast-food culture, along with conflicting messages about unattainable and unrealistic ideas of body shape cause many to engage in dysfunctional eating habits that can lead to food addictions.

Video games

Many parents recognized the addictive nature of video games in past decades. They are said to affect grades and are linked to ADD. A 2007 study found that “almost 1 out of every 10 youth gamers show enough symptoms of damage to their school, family and psychological functioning to merit serious concern.” 13

Video games are becoming more and more appealing to adults as well. One stuy found that 44% of gamers are between 18 and 49. 13

The advent of online gaming and virtual worlds has caused gaming addictions to reach new highs, especially in Asian nations. These worlds allow one to build or assume another identity and interact with others, heightening the addictive nature of the games.

Internet

Internet addiction is another global concern. The rise in many other addictions can be traced to the advent of the Internet. Gambling, shopping, sex addictions are among them and anorexics have been known to create web sites with “helpful tips” for other self-starving people.

Internet addicts spend more and more time on the computer at the expense of relationships with friends and family, risk their jobs and academics, may become indebted, feel unable to stop spending so much time on the Internet, feel guilty and act secretive about it and experience symptoms of withdrawal when they are away from their computers.

Is addiction a disease or a choice? Is it caused by genetics and/or physiology? Is it the substance or behavior that enslaves people or is it a matter of personal characteristics?

Is addiction a disease or a choice? Is it caused by genetics and/or physiology? Is it the substance or behavior that enslaves people or do some people have personal characteristics that cause them to choose addictive behaviors?

Although addiction has been a recognized phenomenon for centuries, there is still no clear consensus on the definition of addiction.

The World Health Organization (WHO) defines addiction as a mental disorder in which a person engages in the repeated use of a substance “despite knowing and experiencing its harmful effects.” WHO goes on to say that the person has uncontrollable urges to use the substance, needs increasing amounts to achieve previous effects and experiences physical withdrawal symptoms upon stopping use. 1

The American Pain Society, The American Academy of Pain Medicine and the American Society of Addiction Medicine have together put forth definitions concerning drug-related addiction. 2

These organizations define addiction as “a primary, chronic, neurobiological disease, withgenetic, psychosocial, and environmental factors influencingits development and manifestations. It is characterized by behaviorsthat include one or more of the following: impaired controlover drug use, compulsive use, continued use despite harm, andcraving.” 2

The three organizations define physical dependence separately from addiction as a “state of adaptation that is manifested by a drug-class specific withdrawal syndrome.” 2

The American Psychiatric Organization collaborated with the World Health Organization to create criteria for the definition of addiction. 3 positive responses to any of the following questions (in part or as a whole) result in a person meeting the criteria for this medical definition of addiction: 3

Tolerance. Has your use of drugs or alcohol increased over time?

Withdrawal. When you stop using, have you ever experienced physical or emotional withdrawal? Have you had any of the following symptoms: irritability, anxiety, shakes, sweats, nausea, or vomiting?

Difficulty controlling your use. Do you sometimes use more or for a longer time than you would like? Do you sometimes drink to get drunk? Do you stop after a few drink usually, or does one drink lead to more drinks?

Negative consequences. Have you continued to use even though there have been negative consequences to your mood, self-esteem, health, job, or family?

Neglecting or postponing activities. Have you ever put off or reduced social, recreational, work, or household activities because of your use?

Spending significant time or emotional energy. Have you spent a significant amount of time obtaining, using, concealing, planning, or recovering from your use? Have you spend a lot of time thinking about using? Have you ever concealed or minimized your use? Have you ever thought of schemes to avoid getting caught?

Desire to cut down. Have you sometimes thought about cutting down or controlling your use? Have you ever made unsuccessful attempts to cut down or control your use?

Substance abuse is defined separately from addiction by the American Psychiatric Association (APA). People may abuse alcohol or drugs but not be addicted to them. The APA defines substance abuse as: 3

Continued use despite social or interpersonal problems.

Repeated use resulting in failure to fulfill obligations at work, school, or home.

Repeated use resulting in physically hazardous situations.

Use resulting in legal problems.

According to these definitions, addiction, dependence and substance abuse are separate entities, and for the most part, addiction is considered a physiological disease or disorder.

However, drug and alcohol use aren’t the only things that are considered addictions today. Eating disorders, internet use, gambling, even shopping addictions are on the rise. When excessive use or abuse of necessary activities can be considered addiction—how is the definition of addiction affected?

The majority of these organizations view addiction as a disease, and a rising number of scientists propose that addiction is an individual choice. Others consider addiction a socially-derived ill.

This lack of consensus severely affects the study of addiction. Statistics, classifications, diagnoses and the measurement effective treatments are all compromised. Health care coverage and the individual’s perception of the differences between interest, dedication, attention to detail, craving, obsession, compulsion and addiction are ambiguous.4

Addiction is perceived in a social way. Cigarette smoking isn’t considered aberrant or illicit in some cultures. It is the medical, political and social policies that determine the public’s view of what is deviant from the norm. 4

And the fact that addictive activities like gambling or sex can cause physiological effects with both their use and withdrawal challenges much of the perceptions of a disease-model of addiction. 4

Addiction as Disease

The Addictions and Recovery Organization takes the stance that 50% of addiction is due to genetic predisposition and the other 50% is due to poor coping skills.5 The organization bases this view on family histories, twins studies and changes in neuro-functioning of the brain in addicts.

The problem with this proof is that family environments can influence the development of addiction in twins and others and that mind-body medicine is providing proof that thinking, behavior and nervous system wiring are all very inter-related. That 50% genetic basis can not isolated from environmental effects. Furthermore, we know today that both environment and behavior can influence the expression and evolution of genes.

Dr. John Halpern believes in the disease model of addiction. He uses cigarette smoking as an example. Although the dangers of smoking are well known today and has been nearly criminalized in public perception; many people are unable to stop smoking. It is not a choice, he says. 6

Halpern also points to twin and family history research as evidence of the biological basis of addiction. 6

He points out that homeostatic changes occur with drug use that sensitizes a person in ways that make them susceptible to relapse, that neurotransmitter receptors and gene expression are decidedly affected by substance abuse and so the substances themselves are the root cause of addiction as a disease. 6

Halpern believes that the view of addiction as choice is faulty because users do not have control: if they did, he believes that they would stop once they recognized the cost/benefit ratio of addiction in their lives. 6

In fact, what most self-help groups recognize is that people are able to stop once they come to re-value social relationships and other factors above the use of the drug. 3

What we may view as devastating—the loss of employment, home, marriages, children, self-respect etc.—may, for a long time, still hold a lower place on an addict’s measure of value and priority. It takes a change in individual perception of the positive and negative effects of the substance use and/or activity in order for the cost/benefit ratio to align with publicly perceived values.

Halpern does recognize the value of support groups in helping to change an addict’s perception of cost/value, but he stresses the medical model of addiction and adds that many addictions may have self-medicating components that can be alleviated with proper pharmaceuticals. He even muses that someday, a vaccine will be discovered that provides immunity from cocaine addiction! 6

Halpern believes that viewing addiction as a disease can help temper social stigma, reduce persecution of the individual, shift responsibility for addiction from the individual’s shoulders and to society’s, increasing acquisition of treatments for the disorder. 6

Dr. Howard Shaffer doesn’t hold with the disease model of addiction. He points out that neuroadaptation and addiction are two very different things. 4

Neuroadaptation refers to physiological changes resulting from addiction. The transforming of neurotransmitter activity in increasing tolerance, relapse risk etc., are physical manifestations of addiction to substances.

He points out that post-operative patients can become physically dependent upon pain-killers but don’t display addictive behaviors. He stresses that addiction includes behavior patterns that are not solely the result of neuroadaptation and points out that evidence is building that finds addictive behaviors (not just the physical properties of substances) such as gambling can contribute to physiological changes. 4

Shaffer also points out that many people who are genetically prone to addiction do not develop the disorder, that use of a drug doesn’t always result in addiction and that personal characteristics aren’t a consistent predictor of addiction either.4

Shaffer believes that the more we learn about the biology of addiction, the more evident it becomes how much social and cultural influences affect its development. 4

Addiction as Choice

Author of Addiction Is a Choice, Dr.Jeffrey Schaler, bases his view on two major points: the first is that “many activities that are not themselves diseases can cause diseases” and secondly, “foolish, self-destructive activity is not necessarily a disease.” 7

Schaler speaks of drug use when he asks: If a person uses drugs, does this act cause a disease? He believes that it is instead a behavior and so—a choice. 7

Schaler points out that addiction does not necessarily include lack of control. The alcoholic does not drink him or herself to death in one sitting. Instead, they choose and plan for a period of recovery between binges. This, Schaler believes, is evidence that the alcoholic exercises some control over his behavior and chooses his or her rate of consumption (wisely or not.) He also points out that research show that an alcoholic can control his or her behavior in response to incentives. 7

Schaler also believes that the increasing evidence of relationship between mind and body has been misconstrued by conventional medicine. Instead of looking at the emergent properties of a single and holistic system, there is a tendency to view mental and personality processes as being caused by physiological processes. 7

Grief, Schaler says, is a trauma that can occur along with corresponding physical attributes but that doesn’t mean that the event alone causes the physical symptoms. In the same way, substance use can cause physiological changes that in turn are correlated with different mental states but, chemical rewards themselves do not have the ability to compel people’s behavior. It is the person’s choice and will that determines whether or not they ingest a drug or eat a fattening food. 7

The widespread use of self-help groups such as Alcoholics Anonymous provides more evidence to discredit the disease model of addiction, Schaler says. These groups have a strong religious component, which illustrates the ethical nature of the treatment and the problem. 7

Self-help groups may be more effective than psychotherapy, Schaler believes, because most therapy is based on the disease model, prompting patients to accept that the addiction is physiological and therefore beyond much of his or her conscious control. This abnegation of responsibility undermines therapy meant to help an addict change their values or behaviors. 7

Addiction as a Social Ill

Although genetics and a substance’s characteristics can play a part in the development of addiction, other common causes are thought to be: 8

Self-medicating for anxiety and depression

Environmental influences and learned habits

Lack of religious affiliation

Lack of coping skills

Physical or sexual abuse

Low self-esteem

Accessibility and familiarity

In 1983, The National Academy of Sciences recognized the following common personality traits in various addictions: 9

A high value on nonconformity combined with a weak commitment to the goals for achievement valued by the society.

A sense of social alienation and a general tolerance for deviance.

A sense of heightened stress. This may help explain why adolescence and other stressful transition periods are often associated with the most severe drug and alcohol problems.”

Some researchers note that addictions are a product of social, psychological and physiological components. 10

Personality is not simply a result of genetics but social and cultural influences, so focusing on common characteristics of addicts can be a limiting view too. The high rate of addiction among physicians, for example, could be due to availability, stress and personality. 10

Dr. Robert Millman describes the “non-addict” personality as “those who have strong families, often with religious backgrounds and who have good social relations.” 10

The recent book, The Globalisation of Addiction, by Dr.Bruce Alexander poses a social theory of addiction. 11

He thinks of addiction as “overwhelming involvement” with any substance or activity. He does not believe addictions, compulsions and obsessions are distinct or distinguishable from each other. 11

Alexander does not think of addiction as a medical condition or disease and points out that this view and its treatments have proved widely unsuccessful in curing or preventing addiction. 11

He believes that addictions exist on a continuum of harm and that they are a recurrent and rising social phenomenon in western countries and all large civilizations throughout history. 11

This phenomenon helps us to think of addiction, says Alexander, as not a matter of “enslavement” to pernicious substances and not a matter of disease, but as a philosophical issue pervasive throughout the history of the human condition. 11

Addiction, he says, is an individual and social response to dislocation, the opposite of psychosocial integration.

In the chapter, Poverty of Spirit, Alexander explains that psychosocial integration is “a profound interdependence between individual and society that normally grows and develops throughout each person’s lifespan [and is] experienced as a sense of identity because stable social relationships provide people with a set of duties and privileges that define who they are in their own minds.” 11

This social bonding is what makes life bearable and is the key to humanity flourishing in creativity and cooperation. Addiction, stresses Alexander is the adaptation response to this psychological and social separation, or what we commonly think of as alienation and disconnection. 11

Our current culture, Alexander says, is a powerful catalyst for every kind of dislocation and so…all kinds of addiction. 11

He quotes Karl Marx in his effort to capture the upheaval and change that a rising tide of capitalism brings:

“Constant revolutionizing of production, uninterrupted disturbance of all social conditions, everlasting uncertainty and agitation distinguish the bourgeois epoch from all earlier ones. All fixed, fast frozen relations, with their train of ancient and venerable prejudices and opinions, are swept away, all new-formed ones become antiquated before they can ossify. All that is solid melts into air, all that is holy is profaned.” 11

The crumbling and morphing of economic, familial, political, religious and social institutions is behind the rising rates of addiction. A perspective such as this helps us to view addiction in a holistic way that offers pathways to recovery for both individuals and society at large.

Bruce Alexander works with Vancouver addicts. He insists that they need community, belonging, usefulness and positive group identities in order to abstain from their addictions,11 just as all global citizens do.

Psychosis is a catch-all term that describes an inability to perceive and react to reality. Modern therapy goals directly deal with quality of life issues along with symptom control. With several agents available, one might find the best fit for any particular patient.

Psychosis

Psychosis is a catch-all term that describes an inability to perceive and react to reality. Hallucinations, delusions and other thought disorders are present. This is not a physiological definition because the exact etiology and causes of psychosis are not precisely understood. Diagnosis is made by observation and interview (sometimes with family and friends).

A naïve public, inexperienced with psychotic patients, sometimes assumes a philosophical waffling – after all, don’t we all perceive reality differently? But for anyone who has interacted with a psychotic person, the condition is strikingly apparent. These patients are not faking, not joking, and are seriously impaired. Their altered mentation may be dangerous for themselves or others around them.

Historically, the goal of treatment was control of the patient. The degree of confinement was related to the severity of symptoms and very little was offered to ameliorate suffering other than time and hope. Physical and chemical restraint was common. The stories of what amounted to abuse by the medical profession remain an unfortunate black mark on Psychiatry.

Even today, psychosis remains a condition that society at large chooses to shun. The sight of a mumbling ‘bum’ or a wild-eyed prophet of doom causes consternation and fear in the general public. Depending on the extent of the handicap and the availability of modern psychiatric care, such people are pushed to the edges of society with the most functional becoming holy men and the least functional simply imprisoned.

This situation is the context needed to understand the boon that antipsychotic medications present. While all drugs used have serious side effects and other problems, they represent a solid advance in the treatment of what can be a crippling condition.

Classes

Antipsychotics, also called neuroleptics, are generally classified as typical (first generation) or atypical (second generation). The categories are historical and unnecessarily biased. The distinction is that the typical antipsychotics are classified by their chemical structure (three main types) and the atypical by their mode of action – which receptor subtype they function at. The newest agents are sometimes called third generation. The bias comes about because we are often conditioned to think that newer = better.

The bias remains in spite of a 2005 study by the National Institutes for Mental Health that compared second generation antipsychotics to a the typical agent, perphenazine. Only olanzapine had less discontinuation due to side effects (the primary metric). For updates and info, see the CATIE project.

Prevailing practice suggests the use of newer agents as a first trial upon diagnosis, with the expectation of a better side effects profile. Patients who have been stabilized on older medications, however, should not be switched without good reason and even then with caution.

The typical antipsychotics include the butyrophenones (i.e. Haloperidol); the phenothiazines (i.e. Chlorpromazine); and the thiozanthines (i.e. Flupenthixol).

Atypical or second generation drugs include those which act in various ways on the dopamine neurotransmitter system. They vary in their modes of action and what other neurotransmitter receptor sites they will bind to. This gives rise to a suite of side effect profiles and a ‘menu’ of agents to try. The only commonality among these agents is that they all find use in treating psychosis. Whether they are used primarily for schizophrenia, bipolar disorder or other labeled condition depends largely on a doctor’s preference, patient history, and the availability of studies showing a positive effect for a particular diagnosis. Off label uses are common as doctors attempt to titrate treatment to a particular patient’s condition and responses.

Effects

The first antipsychotic was originally marketed as a surgical adjunct/anesthetic. Chorpromazine was found to have a calming activity with psychotic patients and this opened the door for exploration of similar compounds. The popularity of Thorazine (trade name for chlorpromazine) as an agent to control combative patients is well known and gave us the euphemism, “chemical straightjacket”.

Alleviating hyper-emotional and combative behavior in psychiatric emergencies is still a use for injectable haloperidol (in combination with a benzodiazepine) but long-term management of patients with high-dose antipsychotics is discouraged. This is because side effects are sure to arise. The goal when treating with antipsychotics is to balance symptom relief with the emergence of adverse reactions. It is common, in drug studies for these agents, to lose as much as two-thirds of the cohort because of unwanted reactions.

Some of the more serious adverse reactions include:

Onset of diabetes (especially those of African ethnicity) which may, in some cases be fatal (ketoacidosis) and pancreatitis.

Dramatic weight gain (metabolic, not just behaviorally induced).

Among the typical antipsychotics (and the main side effect reduced in atypical) is tardive dyskinesia, a movement disorder typified by the purposeless, robotic gait referred to cynically as the “Thorazine shuffle”.

Other side effects vary by agent and are often used to differentiate one product over another.

Of special note is a side effect that mirrors the goals of the treatment. Patients will complain of dysphoria, and in the treatment of mania and some types of schizophrenia, this is a nuance of some importance. Because one goal of treatment is to reduce excitability and feelings of grandiosity, a blunting of mood is desired. However, for some patients the treatment is worse than the disease. When emotional response is dulled to the degree that patients no longer care to live their ‘corrected’ life, they often stop taking medications which allow them to function in society. This sort of hard choice, between a less than adequate ‘cure’ and the condition itself is central to the management of psychosis. Another common side effect seen with these agents is sexual dysfunction, also perhaps a consequence of blunted affect and avolition.

Modern therapy goals directly deal with quality of life issues along with symptom control. With the multiple agents now available, several may be tried in an attempt to find the best fit for any particular patient. The practice of prescribing multiple antipsychotics simultaneously is currently discouraged, mostly because this becomes a ‘one-off’ experiment. Peer reviewed studies usually do not use more than one drug at a time. However, as in other areas of medicine that are not clearly, biologically elucidated, it becomes a matter of judgment, and psychiatrists must still rely on best guesses followed by modification.

Conclusion

The advent of medications that helped in psychosis was a large leap forward. Chemical agents have simultaneously helped ameliorate symptoms and shed light on the underlying mechanisms of the disease state. Much remains to be learned and exploration of the brain with fMRI and techniques in molecular biology offer continued improvements in care.

Newer drugs that target glutamate receptors show promise and non-drug therapies (Animal Assisted Therapy as an example) continue to be tried. The field is ripe for advances from several fronts. As always, caution coupled with scientific evaluation is the key.

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